Tronnier V, Pannier G, Gottschalk S, Petersen D, Reusche E, Merz H
Department of Neurosurgery, University Hospital Lübeck, Lübeck, Germany.
Cent Eur Neurosurg. 2010 May;71(2):99-103. doi: 10.1055/s-0029-1237714. Epub 2009 Dec 2.
We present an unusual case of a patient with trigeminal pain and hypesthesia suggesting trigeminal schwannoma, where histology demonstrated an inflammatory lesion of the Gasserian ganglion.
Patient history and imaging were typical for a trigeminal schwannoma with a dumbbell growth in the middle and posterior fossa. Surgery was performed and resection of a firm mass intermingled with fascicles originating from the ganglion and the mandibular branch was carried out via a subtemporal approach. Histological diagnosis revealed a non-caseating, vaguely granulomatous lymphocyte- and histiocyte-rich inflammation.
Inflammatory lesions of the Gasserian ganglion are rare but may mimic tumors. Intraoperative biopsies should be taken prior to complete resection to limit neurological deterioration.