Benign triton tumor (neuromuscular hamartoma) is a rare tumor of the peripheral nerves, comprising mature neural and striated muscle elements. We report the third case, according to the literature, of a benign triton tumor affecting the Vth cranial nerve in a 4-year-old male child. The tumor was seen to involve the mandibular division of the trigeminal nerve in the infratemporal fossa and extend intracranially by eroding the base of middle cranial fossa. The mass was totally excised. In the tumor, bundles of axons intermingling with fascicles of relatively mature skeletal muscle were found. This type of hamartomatous lesions of neuroectodermal-mesenchymal origin could have arisen as the result of incorporation of mesenchymal tissue into nerve sheaths during embryogenesis or aberrant differentiation of neuroectodermal component into mesenchymal elements.

Object Intracranial abscesses located deep in the cerebral parenchyma and in eloquent regions are often difficult to manage surgically. The authors have attempted to analyze the efficacy of stereotactic aspiration in the management of these abscesses. Methods Cases involving 22 patients (including 9 children) with deep-seated and/or eloquent-region intracranial abscesses who underwent CT- or MR imaging–guided stereotactic aspiration between January 1995 and July 2001 were analyzed. Results A definite source of infection could be identified only in 9 of the cases. In 18 patients, the abscess was deep seated, whereas in the rest it was located in the eloquent cortex. Five patients had abscesses located in multiple sites. In 17 patients only 1 aspiration was required; in 5 others subsequent procedures were required. In the initial postaspiration CT, minor hemorrhage was noted in 3 patients not requiring further intervention. Antibiotics were administered for a period varying from 4 to 8 weeks following aspiration. An early recurrence (within 2 weeks of initial aspiration) was evident in 5 patients. All recurrent abscesses were reaspirated. In 2 patients new abscesses developed while the patients were still receiving antibiotic therapy. There were no late recurrences. In 1 patient ventriculitis developed, with subsequent hydrocephalus requiring a shunt insertion. Follow-up CT scans showed complete resolution of the abscess in all patients. There were no deaths. Conclusions Stereotactic aspiration is a useful management option for abscesses located in eloquent or inaccessible regions. Repeated aspiration should be considered in patients in whom the initial aspiration proves ineffective or partially effective. Complete resolution may require repeated stereotactic aspirations and continued antibiotic therapy.

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Cellular schwannomas rarely involve the cranial nerves, being more common in the spinal and peripheral nerves. A rare case of cellular schwannoma involving the gasserian ganglion, a hitherto unreported site, that extended infratentorially to present as a cerebellopontine angle tumor is reported. It is important to recognize that cellular schwannomas can histologically mimic malignant peripheral nerve sheath tumors because of their high cellularity and mitotic activity, but they are relatively benign tumors with a tendency to recur but not metastasize.

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