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Published on: May 26, 2023
[Malignant lymphoma presented as left trigeminal neuralgia]
Miho Akaza1, Taiji Tsunemi, Nobuo Sanjo
1Department of Neurology and Neurological Science, Graduate School, Tokyo Medical and Dental University.
Rinsho Shinkeigaku = Clinical Neurology
|September 1, 2009
Summary
Malignant lymphoma can mimic trigeminal neuralgia, initially presenting as facial pain and trigeminal nerve swelling. Prompt diagnosis and treatment are crucial, even after initial tumor response.
Area of Science:
- Neurology
- Oncology
Background:
- Trigeminal neuralgia can be caused by tumors affecting the trigeminal nerve.
- Schwannomas are a common cause of trigeminal nerve tumors.
Observation:
- A 60-year-old male presented with trigeminal neuralgia and a swollen, enhancing trigeminal nerve on MRI, diagnosed as schwannoma.
- After Gamma Knife radiosurgery, the patient relapsed with unsteadiness and new white matter lesions, revealing diffuse large B cell lymphoma.
Findings:
- Malignant lymphoma can present as trigeminal neuralgia, complicating initial diagnosis.
- High-dose methotrexate and whole brain radiation therapy were effective for the lymphoma, with no recurrence over 30 months.
Implications:
- Accurate diagnosis of trigeminal nerve tumors is challenging without biopsy.
- Regular MRI follow-up is essential, even with initial positive responses to treatment for trigeminal nerve lesions.
