Primary neurolymphomatosis of the trigeminal nerve

Document Type

Article

Abstract

We report a case of a primary malignant lymphoma of the trigeminal nerve that was associated with facial pain. A 65-year-old man was examined at another hospital for unilateral facial pain. Carbamazepine was prescribed, but his symptoms did not improve. Magnetic resonance imaging (MRI) revealed swelling of the trigeminal nerve and a mass lesion in Meckel's cave. The patient was referred to our hospital at this point. Gadolinium-enhanced MRI and F18-Fluorodeoxyglucose-position emission tomography suggested a likely malignant tumour and a biopsy was performed. Histopathological examination showed diffuse a large B cell lymphoma. The patient was treated with high-dose methotrexate (HD-MTX) and radiotherapy. Despite responding well to initial treatment, the patient relapsed, with lymphoma observed throughout the body. He died of pneumonia 18 months after the initial diagnosis. Facial pain is a symptom that is commonly managed in general practice. If symptoms do not improve, repeated imaging studies, including contrast MRI, is warranted. This is the first reported case of primary neurolymphomatosis (NL) of the trigeminal nerve associated with facial pain alone. Furthermore, HD-MTX and radiotherapy may be considered for the management of primary NL of a cranial nerve.

Keywords

HD-MTX, Neurolymphomatosis, radiotherapy, trigeminal neuralgia

Medical Subject Headings

Male; Humans; Aged; Neurolymphomatosis (pathology); Trigeminal Nerve (diagnostic imaging); Lymphoma, Large B-Cell, Diffuse (diagnostic imaging, therapy); Cranial Nerves; Magnetic Resonance Imaging; Facial Pain (pathology)

Publication Date

8-1-2023

Publication Title

British journal of neurosurgery

E-ISSN

1360-046X

Volume

37

Issue

4

First Page

697

Last Page

700

PubMed ID

30741017

Digital Object Identifier (DOI)

10.1080/02688697.2019.1568391

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