A 39-year-old woman presented with a 2-month history of intractable, left-sided facial pain. A CT scan of the thorax disclosed a large lung mass surrounding supra-aortic vessels and hilus. The symptoms underwent a rapid and spontaneous remission after laryngeal nerve palsy with dysphonia developed. Referred facial pain secondary to the compression of the vagus nerve can rarely be the first manifestation of an underlying lung cancer. All cases of unexplained unilateral facial pain should be investigated for a mediastinal pathology, especially in smoker subjects. Key words: facial pain, lung cancer (Headache 2006;46:813-820) Facial pain is a common clinical symptom with a wide spectrum of underlying conditions, including neurological, odontological, and otolaryngological pathologies.1 Atypical or idiopathic facial pain is defined as a persistent pain syn-drome of unknown origin not attributed to another disor-der.2 Rarely, facial pain can be the consequence of diseases involving the thorax, particularly a lung mass. In these cases, the symptoms may be initially misinterpreted for atypical fa-cial pain. We describe a patient in whom facial pain was the presentation symptom of a remote lung carcinoma. CASE REPORT A 39-year-old woman presented with a 2-month history of left-sided facial pain. She experienced a gradual onset, constant, dull pain localized in the superior alveolar and zygomatic regions. The pain was continuous, moderate t
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