Katz J, Singer C, Kashtwari D, Nair MK and Moreb JS
Numb chin syndrome (NCS), or mental nerve neuropathy, is a sensory neuropathy of the mental nerve and is characterized by hypoesthesia, paresthesia, or a numbness sensation of the chin and lower lip. NCS is caused by multiple etiologies including cancer invasion. We present a case series of three multiple myeloma patients with NCS where the jaw symptoms are a manifestation of disease relapse with extra-medullary myeloma infiltration, including soft tissue plasmacytoma involving the mental nerve noted along the jaw bone. The soft tissue plasmacytoma was detected using magnetic resonance imaging (MRI), which is the preferable diagnostic imaging technique to evaluate this type of problem. Furthermore, we found that in all cases, the involved immunoglobulin was IgA. This is interesting because IgA is the main immunoglobulin secreted by salivary glands. In addition, it seems that NCS could serve as one of the ominous prognostic factors in these patients.
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