![]() ![]() Histopathological examination revealed a diagnosis of moderately differentiated squamous cell carcinoma, which on immunohistochemistry was CK5/6 positive. The biopsy of the right upper paratracheal mass was taken by a pulmonary medicine specialist via the endoscopic approach. 2: Axial computed tomographic scan showing soft tissue mass compressing the trachea and enlarged paratracheal lymph nodes (arrow showing a large lesion) No evidence of tumor was found in other parts of body on radiological examination.įig. Full-body scan was done to rule out the primary or metastatic site. There was paratracheal lymphadenopathy with tracheal and esophageal invasion by the mass without involvement of major neck vessels. Laterally, it caused lateral displacement of left parapharyngeal space fat ( Fig. Posterolaterally, the soft tissue mass was extending along the left pharyngeal wall in the tonsillar fossa of approximately of 3.5 × 2 × 3 cm in diameter. Computed tomographic scan of the neck showed a heterogeneous soft tissue mass in the region of base of tongue on left side and extending toward midline. The patient was a chronic cigarette smoker for the last 20 years and there was no history of previous neck pathology and surgery. On clinical examination, there was no abnormality detected in the oral cavity, face, and neck and no any weakness of the facial nerve was there ( Fig. The pain radiated toward parotid, temporal, and neck regions. C ASE D ESCRIPTIONĪ 46-year-old male reported to the unit of oral and maxillofacial surgery with the chief complaint of severe pain in the right preauricular region after taking first bite of each meal, which lasted for a moment and subsided with subsequent masticatory movements from last 6 months. The purpose of this paper is to report an interesting case in which presenting symptom of FBS leads to the diagnosis of squamous cell carcinoma invading to trachea and esophagus. ![]() 2 In the literature, most of the reported cases show occurrence of FBS few days after parapharyngeal surgery. ![]() This hypersensitivity is thought to elicit a supramaximal contraction of myoepithelial cells during the first bite of a meal that subsides with continued masticatory action. Most theories on the pathology of FBS revolve around the concept of sympathetic denervation of the parotid gland with subsequent hypersensitivity of myoepithelial cells to parasympathetic neurotransmitters. It has been mostly associated with surgery of the parapharyngeal space, parotid gland, and upper neck. It is recurring in nature and occurs before every meal. 1 The pain is typically worst with the first bite during the first meal of the day and gradually subsides with successive masticatory movements. I NTRODUCTIONįirst bite syndrome (FBS) is considered as a development of pain in the preauricular region triggered by gustatory stimuli. Keywords: Carcinoma, First bite, Hypopharyngeal cancer, Neck mass, Pain, Pathology. First Bite Syndrome Presenting as Initial Symptom of Soft Tissue Mass in Base of Tongue and Pharyngeal Space Lead to Diagnosis of Squamous Cell Carcinoma Invading Trachea and Esophagus: A Rare Case Report. We are reporting a rare case of preauricular pain after first bite of meal that leads to the diagnosis of squamous cell carcinoma invading the trachea and esophagus. International Journal of Head and Neck Surgery Volume 13 | Issue 2 | Year 2022įirst Bite Syndrome Presenting as Initial Symptom of Soft Tissue Mass in Base of Tongue and Pharyngeal Space Lead to Diagnosis of Squamous Cell Carcinoma Invading Trachea and Esophagus: A Rare Case Reportĭepartment of Oral and Maxillofacial Surgery, Postgraduate Institute of Medical Education and Research, Chandigarh, IndiaĬorresponding Author: Satnam S Jolly, Department of Oral and Maxillofacial Surgery, Postgraduate Institute of Medical Education and Research, Chandigarh, India, Phone: +91 9914287909, e-mail: on: 29 June 2014 Accepted on: 14 July 2022 Published on: 15 September 2022 A BSTRACTįirst bite syndrome (FBS) is considered as a development of pain in the preauricular region triggered by gustatory stimuli. ![]()
0 Comments
Leave a Reply. |