Department of Anatomy, Pomeranian Medical University, 72 Powstańców Wlkopolskich Street, 70-111, Szczecin, Poland.
Adv Exp Med Biol. 2018;1040:23-27. doi: 10.1007/5584_2017_95.
A 60-year-old woman, otherwise in a good health condition, was first admitted to the hospital with a year-long tingling sensations of the right half of the face, which gradually turned into severe neuralgia corresponding to maxillary (V2) and mandibular (V3) branches of the right trigeminal nerve. MRI scans of the head revealed an unusual hyperplastic or inflammatory changes along the brain base, cavernous sinus extending toward the pterygopalatine fossa, and lateral pterygoid on the right side. Meningioma was suspected and neuralgia was treated conservatively. About 2 years later, due to severe facial and eye pain, the patient underwent decompression of trigeminal nerve roots - Janetta's surgery. The following MRI scans revealed a tumor of cavernous sinus, arousing suspicion of malignancy. Histological specimens obtained after a biopsy and then partial transnasal tumor resection yielded a diagnosis of adenoid cystic carcinoma. The patient was treated with proton radiation therapy. The therapy caused burns in the oropharyngeal soft tissues extending from the oral cavity to the throat and esophagus. The additional adverse effect of the therapy was hypoacusis and a damage to the right cornea. A radiation-induced sinusitis appeared that required surgical intervention. The patient suffered a string of further complications, including pneumonia and a transient kidney failure. In the end, the patient survived. The adenoid carcinoma in the currently 64-year-old woman is visibly reduced, but she still suffers from the trigeminal neuralgia. The patient remains under constant laryngological outpatient care as she requires a periodic cleansing of nasal cavities and hypoacusis monitoring.
一位 60 岁的女性，身体状况良好，因右侧面部持续一年的刺痛感首次入院，随后逐渐发展为右侧三叉神经上颌支（V2）和下颌支（V3）的剧烈神经痛。头部 MRI 扫描显示沿脑基底、海绵窦向翼腭窝和右侧翼外肌有异常的增生或炎症改变。怀疑为脑膜瘤，并采用保守治疗神经痛。大约 2 年后，由于严重的面部和眼部疼痛，患者接受了三叉神经根减压术-詹纳塔手术。随后的 MRI 扫描显示海绵窦内有肿瘤，引起恶性肿瘤的怀疑。活检后获得的组织标本和随后的部分经鼻肿瘤切除术提示为腺样囊性癌。患者接受了质子放射治疗。治疗导致口腔至喉咙和食管的口咽软组织烧伤。治疗的另一个不良反应是听力下降和右眼角膜损伤。出现了放射性鼻窦炎，需要手术干预。患者还遭受了一系列其他并发症，包括肺炎和短暂性肾功能衰竭。最终，患者存活下来。目前这位 64 岁的女性的腺样癌明显缩小，但仍患有三叉神经痛。患者仍在接受耳鼻喉科门诊的持续治疗，需要定期鼻腔清洁和听力监测。
