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Mak YH, Ho G. Multicompartmental cystic trigeminal schwannoma as an uncommon differential diagnosis of cerebellopontine angle tumors. Radiol Case Rep 2024; 19:2552-2557. [PMID: 38596177 PMCID: PMC11001620 DOI: 10.1016/j.radcr.2024.03.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2023] [Revised: 02/29/2024] [Accepted: 03/06/2024] [Indexed: 04/11/2024] Open
Abstract
Trigeminal schwannoma is the second most common intracranial schwannoma yet accounts for less than 0.5% intracranial tumors [1]. Cystic degeneration is uncommon. We would like to report a pathologically proven multicompartmental cystic trigeminal schwannoma in a young adult presenting with chronic headache. A literature review on the imaging features of trigeminal schwannoma is performed to assist radiologists in accurate disease localization and prioritizing differential diagnosis in challenging cases. Confident preoperative radiological diagnosis would directly affect management strategies.
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Affiliation(s)
- Yuen Hei Mak
- Department of Radiology, Queen Mary Hospital, Hong Kong SAR, China, 102 Pokfulam Road, Hong Kong SAR, China
| | - Grace Ho
- Department of Radiology, Queen Mary Hospital, Hong Kong SAR, China, 102 Pokfulam Road, Hong Kong SAR, China
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Emedike E, Alnughaythir A, Alsayed N, Alharbi A, Alotibi B. Facial Neuropathy Revealed: A Case Report on Trigeminal Schwannoma. Cureus 2024; 16:e52302. [PMID: 38357058 PMCID: PMC10866083 DOI: 10.7759/cureus.52302] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/15/2024] [Indexed: 02/16/2024] Open
Abstract
Trigeminal schwannomas, rare tumors originating from Schwann cells of the trigeminal nerve, present unique diagnostic challenges due to their infrequent occurrence. The clinical manifestation of facial numbness and tingling necessitates a comprehensive approach for accurate diagnosis and optimal management. We present the case of a 45-year-old female who presented with a six-month history of progressive facial numbness localized to the left maxillary and mandibular regions. Intermittent sharp, shooting pain exacerbated by chewing and cold stimuli was reported. Physical examination revealed sensory deficits in left trigeminal nerve distribution. Magnetic resonance imaging confirmed a well-circumscribed, enhancing lesion along the left trigeminal nerve. Surgical excision of the tumor confirmed the diagnosis of schwannoma. This case underscores the significance of a detailed clinical history, advanced imaging, and collaboration between neurologists and neurosurgeons in achieving an accurate diagnosis and favorable outcome for trigeminal schwannomas. The successful surgical intervention, coupled with histopathological confirmation, contributes to the understanding of these rare tumors.
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Affiliation(s)
| | | | - Naif Alsayed
- General Practice, Shaqra University, Shaqra, SAU
| | - Ahlam Alharbi
- Family Medicine, Primary Health Care Center, Riyadh, SAU
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Battistin U, Maiti T, Elhammady MS, Roser F. Two-Stage Resection of a Giant Trigeminal Schwannoma in a Non-Neurofibromatosis Type 2 Pediatric Patient: A Case Report, Systematic Review, and Intraoperative Video. World Neurosurg 2023; 171:e323-e335. [PMID: 36521756 DOI: 10.1016/j.wneu.2022.12.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2022] [Revised: 12/04/2022] [Accepted: 12/05/2022] [Indexed: 12/14/2022]
Abstract
BACKGROUND Trigeminal schwannoma is an uncommon tumor in pediatric patients. Several surgical approaches have been described in the literature. METHODS The case of an 11-year-old boy with a giant dumbbell-shaped trigeminal schwannoma removed through a 2-stage approach was presented with an intraoperative video. Using PubMed and Scopus, the literature on trigeminal schwannoma in pediatric patients was searched according to the Preferred Reporting Items for Systematic Reviews and Meta-Analysis guidelines. RESULTS The search strategy yielded 312 titles, of which 13 were included in the review. Cases of trigeminal schwannoma were described, with a highly variable clinical presentation and anatomical arrangement in cranial fossae. Two-stage approaches were reported, although most studies described single-stage approaches. Common postoperative outcomes were a range of disturbances of cranial nerve V. CONCLUSIONS The surgical approach varies based on the tumor conformation. However, a 2-stage pterional subtemporal and semisitting retrosigmoid approach is a safe, practical, and effective strategy for the removal of dumbbell-shaped trigeminal schwannoma in a pediatric patient.
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Affiliation(s)
- Umberto Battistin
- College of Medicine, Mohammed Bin Rashid University of Medicine and Health Sciences, Dubai, United Arab Emirates
| | - Tanmoy Maiti
- Department of Neurosurgery, Neurological Institute, Cleveland Clinic Abu Dhabi, Abu Dhabi, United Arab Emirates
| | - Mohammed S Elhammady
- Department of Neurosurgery, Neurological Institute, Cleveland Clinic Abu Dhabi, Abu Dhabi, United Arab Emirates
| | - Florian Roser
- Department of Neurosurgery, Neurological Institute, Cleveland Clinic Abu Dhabi, Abu Dhabi, United Arab Emirates.
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Landry AP, Ye VC, Vaughan KA, Drake JM, Dirks PB, Cusimano MD. Pediatric multicompartmental trigeminal schwannoma: illustrative case. JOURNAL OF NEUROSURGERY: CASE LESSONS 2021; 1:CASE2171. [PMID: 35855022 PMCID: PMC9245852 DOI: 10.3171/case2171] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/05/2021] [Accepted: 02/28/2021] [Indexed: 11/06/2022]
Abstract
BACKGROUND Trigeminal schwannoma (TS) is an uncommon and histologically benign intracranial lesion that can involve any segment of the fifth cranial nerve. Given its often impressive size at diagnosis and frequent involvement of critical neurovascular structures of the skull base, it represents a challenging entity to treat. Pediatric TS is particularly rare and presents unique challenges. Similarly, tumors with extension into multiple compartments (e.g., middle cranial fossa, posterior cranial fossa, extracranial spaces) are notoriously difficult to treat surgically. Combined or staged surgical approaches are typically required to address them, with radiosurgical treatment as an adjunct. OBSERVATIONS The authors presented the unusual case of a 9-year-old boy with a large, recurrent multicompartmental TS involving Meckel’s cave, the cerebellopontine angle, and the infratemporal fossa. Near-total resection was achieved using a frontotemporal-orbitozygomatic craniotomy with a combined interdural and extradural approach. LESSONS The case report adds to the current literature on multicompartmental TSs in children and their management. The authors also provided a simplified classification of TS that can be generalized to other skull base tumors. Given a lack of precedent, the authors intended to add to the discussion regarding surgical management of these rare and challenging skull base lesions.
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Affiliation(s)
| | - Vincent C. Ye
- Divison of Neurosurgery, University of Toronto, Toronto, Ontario, Canada
| | - Kerry A. Vaughan
- Divison of Neurosurgery, University of Toronto, Toronto, Ontario, Canada
- Division of Neurosurgery, Hospital for Sick Children, Toronto, Ontario, Canada; and
| | - James M. Drake
- Divison of Neurosurgery, University of Toronto, Toronto, Ontario, Canada
- Division of Neurosurgery, Hospital for Sick Children, Toronto, Ontario, Canada; and
| | - Peter B. Dirks
- Divison of Neurosurgery, University of Toronto, Toronto, Ontario, Canada
- Division of Neurosurgery, Hospital for Sick Children, Toronto, Ontario, Canada; and
| | - Michael D. Cusimano
- Divison of Neurosurgery, University of Toronto, Toronto, Ontario, Canada
- Division of Neurosurgery, Hospital for Sick Children, Toronto, Ontario, Canada; and
- Division of Neurosurgery, St. Michael’s Hospital, Toronto, Ontario, Canada
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