Trigeminal Schwannoma - Case Report of a Rare Tumour

Surendra K Dabas; Nandini N Menon; Reetesh Ranjan; Bikas Gurung; Sukirti Tiwari; Himanshu Shukla; Ashwani Sharma; Ajit Sinha; Jasbir Singh; Rishu Singal

doi:10.1007/s12070-022-03405-6

Trigeminal Schwannoma - Case Report of a Rare Tumour

Indian J Otolaryngol Head Neck Surg. 2023 Jun;75(2):1180-1185. doi: 10.1007/s12070-022-03405-6. Epub 2023 Jan 9.

Authors

Affiliations

¹ Department of Surgical oncology, BLK- MAX Super specialty hospital, Pusa road, Rajendra Place, 110005 Delhi, India.
² Senior consultant in surgical oncology, Department of Surgical oncology, BLK- MAX Super specialty hospital, Pusa road, Rajendra Place, 110005 Delhi, India.
³ Department of Surgical oncology, FHNO Fellow, BLK- MAX Super specialty hospital, Pusa road, Rajendra Place, 110005 Delhi, India.

PMID: 37274992
PMCID: PMC10235234 (available on 2024-06-01)
DOI: 10.1007/s12070-022-03405-6

Abstract

Schwannomas are benign nerve tumours arising from the Schwann cells. Approximately 25-45% of schwannomas occurs in the head and neck region. Majority of schwannomas in the head and neck region arise from the vagus nerve. Trigeminal schwannomas account for about 0.2% of all intracranial tumours. Trigeminal schwannomas can originate from any section of the fifth cranial nerve, from the root to the distal extracranial branches, but majority develops from the Gasserian ganglion, usually growing in the middle cranium. Most common presenting symptom is facial pain. MRI is the imaging modality of choice and CT scan usually serves as a supplementary imaging especially for skull base tumours. 47 year old male patient presented to the outpatient department with complains of swelling over the left side of palate. Contrast enhanced CT scan demonstrated a large bilobed heterogeneously enhancing soft tissue lesion in the left infratemporal fossa with widened foramen ovale and extension of lesion into the Meckel's cave, larger contiguous component extending into ramus of mandible. MRI scan showed a large lobulated mass in the left masticator space with intracranial extension. Biopsy of the lesion was suggestive of schwannoma. The patient underwent left composite resection with dural repair and free flap reconstruction. Post operatively, on day 5 he developed features of meningitis for which he was treated conservatively and later discharged in stable condition. Trigeminal schwannomas are rare tumours with very low chance of malignant transformation which commonly presents with facial pain. MRI is the imaging modality of choice. Complete surgical excision is the treatment of choice.

Keywords: Infratemporal fossa; Schwannoma; Trigeminal nerve.

© Association of Otolaryngologists of India 2022. Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.