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Article: Volume 49 Number 4 Page 330 - April 2022

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  Dental Update 499: 330-334

Oral surgery:  A Difficult Diagnosis of Spontaneous Lower Lip Numbness

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Abstract: Lymphomas in the head and neck region (HNR) can be a diagnostic challenge owing to their indistinctive oral manifestations that frequently mimic other pathologies. This case report highlights a young male who experienced spontaneous paraesthesia of his lower lip with an accompanied localized dull ache. Initial clinical examination and investigations were inconclusive. A definitive diagnosis of extranodal low-grade B-cell non-Hodgkin lymphoma (NHL) was only confirmed after the second incisional biopsy, which was 15 months after onset of symptoms. This report offers insight of NHL in the HNR and its clinical presentation. It aims to improve awareness amongst dental practitioners to aid early diagnosis.

Clinical relevance: The reader should consider lymphomas as a differential diagnosis for unexplained symptoms, including paraesthesia, mucosal ulceration and soft tissue swelling.

Author notes: Nisma Patel, BDS, MFDS RCS (Edin), PgCert Med Ed, Specialty Dentist (Oral Surgery), Oral Surgery Department, Guy’s and St Thomas’ NHS Foundation Trust, London. Lara Zebic, BDS, MFDS RCPSG, Specialist Registrar (Oral Surgery). Royal London Hospital, Barts Health NHS Trust. Vinod Patel, BDS (Hons), MOralSurg RCS Eng, FDSRCS, PhD, Consultant (Oral Surgery), Oral Surgery Department, Guy’s and St Thomas’ NHS Foundation Trust, London. email: vinod.patel@hotmail.co.uk

Objective: To highlight the importance of spontaneous lower lip numbness as a sign and symptom.