Trigeminal Ganglioneuroma in the Middle-posterior Cranial Fossa: a Case Report△

Abstract

CASE DESCRIPTIONA 49-year-old male patient with no previous comorbidities presented to our hospital with a main complaint of discontinuous dizziness for one month. The dizziness was paroxysmal onset without obvious cause. General physical examination demonstrated right facial muscle atrophic, with no other abnormality. All the neurologic examination was negative.Computed tomography (CT) scan of the brain discovered a slight hypodensity mass (4.2cm×5.2cm) in the right middle-posterior cranial fossa with internal high-density dots in the tumor (Fig. 1A). The tumor deformed the ethmoid bone, destroyed the greater wing of the sphenoid bone and the petrous apex area, and extended to the carvernous sinus and posterior cranial fossa. The pons was compressed. CT value of the spotty high-density was about 350HU, consistent with localized intratumoral calcification and hemorrhage. CT images in bone window demonstrated absorption and thinning of the sphenoid and ethmoid bone without destruction (Fig. 1B). The brain magnetic resonance imaging (MRI) showed a 4.1cm×5.4cm×4cmwell-circumscribed extra-axial mass in the parasellar and cerebellopontine angle region of right middle-posterior cranial fossa (Fig. 2). The right fifth-sixth cranial nerve was displaced by the mass. The lesion demonstrated heterogeneous isointensity or slight hypointensity on T1-weighted image (T1WI), heterogeneous hyper-to slight hypointensity on T2-weighted image (T2WI) (Fig. 2A). It compressed G

Trigeminal Ganglioneuroma: A rare case of trigeminal neuralgia caused by Meckel’s cavum tumor: a case report and review of the literature

“…Frontorbitozygomatic and anterior petrosal approach was used. Tumor resection through a preauricular subtemporal interdural approach was reported by Wang [6]. We used the subtemporal epidural approach in our case with success.…”

“…This finding is very rare. A review of literature can find only a few intracranial GN and only six cases involving trigeminal nerve [1][2][3][4][5][6][7].…”

“…According to the international neuroblastoma pathology classification of neuroblastic tumors, GN has been divided into two subtypes: maturing and mature subtype. Typical GN is composed of mature ganglion cells and schwannian stroma; however, tumors with entirely maturated ganglion cells are rare (approximately 7%) [6] Immunohistochemically, it is characterized by reactivity for S-100, vimentin, synaptophysin, and neuronal markers. In our case; tumor cells were positive for S-100 protein by immunohistochemical staining and no immunoreactivity was noted with anti GFPA, antibody anticytokeratine (17, cytokeratin 7).…”

“…In our case; tumor cells were positive for S-100 protein by immunohistochemical staining and no immunoreactivity was noted with anti GFPA, antibody anticytokeratine (17, cytokeratin 7). Ki-67 is also an immunomarker of cellular proliferation [6].…”

“…Ganglioneuromas (GN) are benign tumors of neural crest origin, which arise from the peripheral nervous system or adrenal glands. Intracranial involvement of GN is extremely rare and there have been only six cases reported of GN arising from the trigeminal nerve until 2017 [1][2][3][4][5][6][7].…”