Granular cell tumour of the cavernous sinus: A rare cause of secondary trigeminal neuralgia

Br J Neurosurg. 2023 Aug;37(4):843-847. doi: 10.1080/02688697.2019.1673314. Epub 2019 Oct 25.

Abstract

Background: Cavernous sinus tumours comprise 0.1-0.2% of all intracranial tumours, and are most commonly meningiomas or schwannomas. Central nervous system and cranial nerve granular cell tumours (GCTs) are extremely rare. We report the tenth case of a GCT arising from a cranial nerve, and the second case reported in a cavernous sinus location, and review the literature.

Clinical presentation: A 67-year-old man presented with right sided trigeminal neuralgia. Imaging findings suggested a trigeminal schwannoma and he was treated with CyberKnife radiosurgery. Over a period of 41 months follow up, there was a progression in both symptoms and imaging findings, requiring debulking surgery. Histopathology identified a GCT.

Conclusions: This is the first case of a cranial nerve GCT treated with stereotactic radiosurgery. Trigeminal nerve GCTs are a rare differential in cases of presumed schwannomas.

Keywords: Cavernous sinus; cranial nerve; granular cell tumour; stereotactic radiosurgery; surgery.

Publication types

  • Case Reports

MeSH terms

  • Aged
  • Cavernous Sinus* / diagnostic imaging
  • Cavernous Sinus* / pathology
  • Cavernous Sinus* / surgery
  • Granular Cell Tumor* / complications
  • Granular Cell Tumor* / pathology
  • Granular Cell Tumor* / surgery
  • Humans
  • Magnetic Resonance Imaging
  • Male
  • Meningeal Neoplasms* / surgery
  • Neurilemmoma* / complications
  • Neurilemmoma* / diagnostic imaging
  • Neurilemmoma* / surgery
  • Radiosurgery*
  • Trigeminal Neuralgia* / diagnostic imaging
  • Trigeminal Neuralgia* / etiology
  • Trigeminal Neuralgia* / surgery