Abstract
Burkitt lymphoma is a highly malignant B-cell tumor characterized by rapid progression. The patient was an 18-year-old boy who had mental paresthesia and spontaneous pain of the mandible as initial symptoms. We initially considered that he might have a malignant tumor, so we performed several examinations. We recognized radiographic changes in his mandible, but were unable to find any tumor lesions or lymph node swelling in his maxillofacial or cervical area. Therefore, we performed further examinations to determine the diagnosis. Around the same time as these initial examinations, several generalized lesions became obvious clinically. He was ultimately diagnosed with Burkitt lymphoma. His condition improved after the administration of CODOX-M/IVAC chemotherapy, and subsequent PET-CT imaging showed there had been a complete response. However, the lesion recurred, and he died one year after his first visit. Narrowing the differential diagnosis in the present case would have been difficult, especially given that the invisible malignant lymphoma occurred in the head and neck area. However, if a patient has a subjective symptom such as mental paresthesia, when cancer cannot be ruled out clinically, the tumor may be a hematopoietic malignancy, a malignant lymphoma, or possibly a distant metastasis of another organ malignancy. In such cases, performing an early general examination such as a PET-CT may lead to a more rapid diagnosis.
