| Summary: | Objective: To present an uncommon presentation of metastatic non-small cell lung cancer at mandible causing
numb chin syndrome (NCS), diagnosed by PET/CT scan.
Case presentation: A 72-year-old man presented with decreased sensation of left lower lip without motor deficit or
taste alteration, so-called NCS. Work up was initially focused on benign etiology as the patient had no known malignancy.
However, malignancy was suspected after excluding all possible benign causes. Further investigation showed high
level of adenocarcinoma markers and a lytic lesion at sacrum leading to provisional diagnosis of bone metastasis
with unknown primary cancer. The subsequent fluorine-18 fluorodeoxyglucose positron emission tomography/
computerized tomography (18F-FDG PET/CT scan) showed a pulmonary mass, representing primary lung cancer
with multiple metastatic sites, including the destructive lesion at left mandible which was a cause of NCS.
Conclusion: NCS could be an atypical presentation of malignancy. Among several investigations for NCS, PET/
CT scan may rarely be used. However, PET/CT scan may provide substantial benefits, particularly for metastatic
disease with unknown primary cancer.
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