Neurotropic Melanoma of the Trigeminal Nerve: A Case of Atypical Facial Pain

Walters, H.B.; Lewis, Emma L.; Wolper, Regina A.; Yachnis, Anthony T.; Green, Jim; Lewis, Stephen B.

doi:10.1016/j.joms.2006.11.033

Cited by 10 publications

(9 citation statements)

References 9 publications

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“…4,5,9,10,12,13,25 This fact, combined with the propensity for neural infiltration, has resulted in many reported cases of desmoplastic neurotropic melanoma associated with cranial neuropathies and neuralgias. 4,8,10,20,21,23,26 Other sites of involvement such as the foot 14 and vulva 18,22 have been reported. There is a high rate of local recurrence, and in some cases, recurrence may be attributed to prior misdiagnosis.…”

Section: Discussionmentioning

confidence: 99%

Malignant Melanoma With Neural Differentiation

Dry

Binder

et al. 2014

The American Journal of Dermatopathology

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The term neurotropic melanoma has been used to refer to malignant melanoma with associated infiltration of nerve or “neural differentiation”—that is, melanoma cells exhibiting cytological characteristics of nerve cells. Historically, neurotropic melanoma has generally been discussed within the context of desmoplastic melanoma. We report an exceptional case of melanoma notable for a very well-differentiated neural component that was contiguous with obvious overlying melanoma. After careful consideration of all pertinent histological features, the overall diagnostic impression was that of melanoma with associated “malignant neurotization.” We have not encountered a previously reported case with such a well-differentiated neural component. The following article details our exceptional case of melanoma with “malignant neurotization” and presents a discussion of the differential diagnosis and brief review of the pertinent literature.

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Section: Discussionmentioning

confidence: 99%

Malignant Melanoma With Neural Differentiation

Dry

Binder

et al. 2014

The American Journal of Dermatopathology

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“…Neural extension or invasion can occur along large or small nerves, [6, 24] including cranial nerves, [2, 6, 7, 13, 18, 24, 25] most commonly the facial and trigeminal nerves [12, 18, 26]. Extended latent periods can exist between initial diagnosis and neural involvement that usually presents as a symptomatic neuropathy [7, 18, 25, 26].…”

Section: Clinical Considerationsmentioning

confidence: 99%

“…Extended latent periods can exist between initial diagnosis and neural involvement that usually presents as a symptomatic neuropathy [7, 18, 25, 26]. Perineural spread of disease can occur beyond the skull base into Meckel's cave, the cavernous sinus and brain, and also expand in an antegrade fashion to include other cranial nerves [18].…”

Section: Clinical Considerationsmentioning

confidence: 99%

“…An average latent period of 4.9 years (range 1.5–12 years) between initial diagnosis and recurrence into cranial nerves was reported in an eight-case respective study in 2004 [12, 18]. Presentation may include cranial nerve palsies, pain, numbness, difficulty with mastication, associated atrophy of jaw muscles, and the absence of corneal reflexes [7, 18, 25, 26]. One case of large nerve invasion outside of the head and neck involving the dorsal cutaneous branch of a spinal nerve has been reported [12].…”

Section: Clinical Considerationsmentioning

confidence: 99%

“…Delay in diagnosis can arise from a benign histopathological appearance [19]. Consideration of the diagnosis is key to early diagnosis and improved outcome [25]. …”

Section: Clinical Considerationsmentioning

confidence: 99%

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Neurotropic Melanoma: The Management of Localised Disease

Croker¹,

Burmeister

Foote

2012

Journal of Skin Cancer

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Neurotropic melanoma is a rare subtype of cutaneous malignant melanoma. Compared with conventional melanoma, it is more locally aggressive with an increased tendency for local recurrence but less likely for nodal or distant metastases. These tumours can be a diagnostic dilemma with a variety of morphological, histopathological, and immunophenotypical expressions. The often amelanotic, benign appearance may lead to treatment issues such as late presentation, diagnostic delay, misdiagnosis, insufficient surgical margins, and recurrence with resulting poor outcome. The neurotropic nature of the disease and prevalence in the head and neck region can result in perineural and neural invasion along named large nerves into the brain with resulting neuropathies. Wide local excision with adjuvant radiotherapy where indicated remains the current practice for treatment with chemotherapy predominately being reserved as a salvage treatment for patients with disseminated disease.

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Plexus and peripheral nerve metastasis

Gwathmey

2018

Handbook of Clinical Neurology

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Neurotropic Melanoma of the Trigeminal Nerve: A Case of Atypical Facial Pain

Cited by 10 publications

References 9 publications

Malignant Melanoma With Neural Differentiation

Malignant Melanoma With Neural Differentiation

Neurotropic Melanoma: The Management of Localised Disease

Plexus and peripheral nerve metastasis

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