Novel CT-guided biopsy of isolated perineural spread of adenoid cystic carcinoma along the trigeminal nerve masquerading as chronic trigeminal neuropathy

J Med Imaging Radiat Oncol. 2017 Feb;61(1):77-81. doi: 10.1111/1754-9485.12557. Epub 2016 Nov 9.

Abstract

The differential diagnoses for chronic peripheral neuropathy are broad and diagnosing a cause can be challenging. We present a case of isolated perineural spread of adenoid cystic carcinoma to the trigeminal nerve involving skull base foramina and Meckel's cave in the setting of chronic trigeminal neuropathy and no known prior malignancy. Computed tomography-guided core (CT) needle biopsy was needed to arrive at a diagnosis and a novel approach was required to obtain tissue from the trigeminal nerve lesion at foramen ovale.

Keywords: adenoid cystic carcinoma; neoplasms; peripheral neuropathy; trigeminal nerve diseases.

Publication types

  • Case Reports

MeSH terms

  • Aged
  • Carcinoma, Adenoid Cystic / diagnostic imaging
  • Carcinoma, Adenoid Cystic / pathology*
  • Chronic Disease
  • Diagnosis, Differential
  • Female
  • Head and Neck Neoplasms / diagnostic imaging
  • Head and Neck Neoplasms / pathology*
  • Humans
  • Image-Guided Biopsy / methods
  • Radiography, Interventional*
  • Tomography, X-Ray Computed*
  • Trigeminal Nerve / diagnostic imaging*
  • Trigeminal Nerve / pathology
  • Trigeminal Nerve Diseases*