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Arch Intern Med. 2004;164:1347-1348.

	Since this article does not have an abstract, we have provided the first 150 words of the full text and any section headings.

Charles Bell initially described the numb chin syndrome (NCS) in 1830. Although the syndrome is frequently described in the dental, oncology, and neurology literature, its importance as a symptom of underlying, progressing, or relapsing malignant disease remains unrecognized by most primary care physicians. Below is a case of Burkitt cell acute lymphoblastic leukemia presenting with NCS as both an initial manifestation of the disease and its subsequent relapse.

Report of a Case

A 33-year-old woman was well until 2 weeks prior to admission, when she noted the onset of fatigue, sweats, and chin and jaw numbness and paresthesias. She was evaluated by her physician and treated supportively. One week later her symptoms were worse. A complete blood cell count revealed pancytopenia, and she was admitted to the hospital. There was no preceding trauma to the jaw or teeth, and she found nothing that relieved her symptoms. Her medical history included depression, anxiety, and constipation. . . . [Full Text of this Article]

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Jon M. Sweet, MD
Roanoke, Va

Corresponding author: Dr Sweet, Carilion Health System, Medical Education Department, PO Box 13367, Roanoke, VA 24033 (e-mail: jsweet@carilion.com).