Cases reported "Cranial Nerve Neoplasms"

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1/46. Trigeminal ganglioneuroma.

    We present the case of an 8-year-old girl with a ganglioneuroma in the left cerebellopontine angle region. The tumor originated from the sensory root of the trigeminal nerve. Histopathologically, it was composed of neoplastic ganglion cells and schwann cells, leading us to the diagnosis of ganglioneuroma. Intracranial ganglioneuroma is very rare. To our knowledge, this is the first report of a trigeminal ganglioneuroma. The nature and origin of this tumor are discussed and the literature reviewed.
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2/46. Differential diagnosis of idiopathic inflammatory trigeminal sensory neuropathy from neuroma with a biopsy: case report.

    OBJECTIVE AND IMPORTANCE: Idiopathic inflammatory trigeminal sensory neuropathy (IITSN) is a disorder with the dominant clinical features of trigeminal sensory disturbance; this idiopathic condition follows a benign course in most cases. Recent reports have shown that transient abnormalities, which may mimic those of trigeminal neuromas, can be observed in magnetic resonance imaging scans. Presented here is a case of IITSN that was diagnosed, with cytological and histopathological verification, during the active inflammatory phase of the disease (the first such attempt, to our knowledge). CLINICAL PRESENTATION: A 20-year-old female patient was referred to our hospital with a 2-month history of numbness of the left side of her face, headache, and hemifacial pain attacks. Cranial magnetic resonance imaging scans revealed a mass above and below the foramen ovale, extending into the cavernous sinus. INTERVENTION: A percutaneous biopsy procedure through the foramen ovale was performed; the pathological examination revealed lymphocytes, macrophages, and endothelial cells but no evidence of neoplastic cells. A few days later, the patient was surgically treated using a cranial base approach, the gasserian ganglion was exposed, and the lesion was removed. Pathological examination of the specimens revealed inflammatory changes and fibrosis of the nerve fibers and ganglion cells. Disruption of the myelin around the nerve bundles was detected. Therefore, IITSN was pathologically confirmed during the early stage of the disease. During 3 months of follow-up monitoring, the patient experienced no serious clinical problems. CONCLUSION: IITSN should be suspected in cases of tumors involving the cavernous sinus, and a percutaneous biopsy through the foramen ovale should be performed as part of the differential diagnosis in such cases. This procedure might obviate unnecessary aggressive surgery. In the current case, no neoplastic cells were observed during the examination; only lymphocytes, macrophages, and endothelial cells were observed, on a background of erythrocytes. Lymphocyte-dominant inflammatory infiltration, fibrotic changes, and demyelinization are cardinal histopathological findings observed during the active phase of IITSN.
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3/46. facial nerve neurinoma presenting as middle cranial fossa and cerebellopontine angle mass: a case report.

    facial nerve neurinomas are rare. The tumours arising from the geniculate ganglion may grow anteriorly and superiorly and present as a mass in the middle cranial fossa. Only a few cases of facial nerve neurinomas presenting as middle cranial fossa mass have so far been reported. These tumours present with either long standing or intermittent facial palsy along with cerebellopontine angle syndrome.
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4/46. hemangioma of the facial nerve.

    To discuss the interest of the etiologic diagnosis of a facial palsy. STUDY DESIGN AND patients: Two cases of geniculate ganglion hemangioma with progressive facial palsy are reported. RESULTS: hemangioma of the facial nerve is a rare and benign vascular tumor that originates from the venous plexus surrounding the facial nerve. The most common locations are the internal auditory canal and the geniculate ganglion. diagnosis of these small tumors is radiological with CT-scan and MRI studies. Surgical excision through a supra-petrosal approach is the gold standard treatment. Hemangiomas of the facial nerve and particularly those developed in the geniculate ganglion area constitute a rare but not inconsiderable facial palsy etiology. An acute diagnosis and an early excision are fundamental to preserve a satisfactory facial function.
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5/46. hemangioma of the porus acusticus. Impact of imaging studies: case reports.

    Hemangiomas are tumors. Hemangiomas near the geniculate ganglion or in the internal acoustic meatus are well known but rare. We present two cases of hemangiomas located at the porus acusticus, an even more rare site. MRI showed a millimeter-sized tumor, located in the porus acusticus, developing perpendicular to the axis of the acoustico-facial nerves, surrounding them. They were hyperintense on T1-weighted images, strongly hyperintense on T2-weighted images with a characteristic progressive and marked enhancement after injection of gadolinium dtpa. Similar signal abnormalities were present in the adjacent temporal bone, and CT scan demonstrated a honeycomb appearance with intratumoral bony spicules. These imaging criteria allows differentiation between hemangioma and neurinoma. We hypothesize that this location is related to the presence of a rich vascular plexus of the dura mater in this area.
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6/46. An unusual bilateral cervical paraganglioma: a case report.

    Paragangliomas are neoplasms originating from paraganglion tissue derived from mesoderm, the most common location being adjacent to carotid bifurcation. Rarely these tumours can be bilateral. We present here a case of bilateral paraganglioma occurring in a young woman. On one side the tumour was arising from the vagus nerve and on the other, from the carotid body. Clinical, radiological and histopathological features and treatment dilemmas are discussed.
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7/46. Multiple familial facial glomus: case report and review of the literature.

    Facial paraganglioma is an extremely rare tumor that originates from abnormal paraganglionic tissue situated in the intrapetrous facial canal. A review of the English-language literature shows that only 8 cases of facial nerve paraganglioma have been published. In each case the facial glomus presented itself sporadically, completely independent of any other form of paraganglioma. This study reports an intrapetrous facial glomus that occurred in a case of multiple paragangliomas with a hereditary pattern. To our knowledge, this is the first report of such a combination.
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8/46. Electrically evoked auditory brainstem response monitoring of auditory brainstem implant integrity during facial nerve tumor surgery.

    evoked potentials identified as electrically evoked auditory brainstem responses (EABRs) have been recorded from a patient in response to electrical stimulation of the cochlear nucleus via an auditory brainstem implant. Recording such EABRs during surgery for removal of an ipsilateral facial nerve tumor provided a means to monitor the integrity of the implant. The presence of stable EABRs similar to those obtained before surgery indicated that the lead wires had not been severed and that the implanted electrodes had not been dislodged. EABR recording may also be useful for assisting with positioning the stimulating electrodes during initial implantation surgery, by verifying that stimulation can activate the auditory system.
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9/46. Neurinoma of the third, fourth, and sixth cranial nerves: a survey and report of a new fourth nerve case.

    A rare case of trochlear nerve neurinoma is described. Including this case, the number of reported intracranial tumors arising from the sheaths of the third, fourth, and sixth cranial nerves is 38. By site and relationship to the nerve segment, they fall into three groups: cisternal, cisternocavernous, and cavernous. In cisternal tumors of the third and sixth nerves, paresis of the nerve hosting the tumor is the unique nerve deficit; by contrast, in those of the fourth nerve, paresis of the trochlear nerve can be absent and that of the third nerve present. In the latter tumors, a peculiar ataxic hemiparesis syndrome is produced by midbrain compression. Cisternocavernous neurinomas often cause symptoms of intracranial hypertension, while cavernous neurinomas bring about two clinical features: paresis of one or more nerves of the cavernous sinus and a clinicoradiological orbital apex syndrome. At surgery, generally cisternal neurinomas are totally removed and the nerve source of the tumor identified; in cisternocavernous and cavernous neurinomas, total removal of tumor and identification of the parent nerve have been reported in only half of the cases. In the majority of parasellar neurinomas, clinical differences can be found between those arising from the nerves governing eye movement and those arising from the gasserian ganglion.
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10/46. A rare case of cellular schwannoma involving the trigeminal ganglion.

    Cellular schwannomas rarely involve the cranial nerves, being more common in the spinal and peripheral nerves. A rare case of cellular schwannoma involving the gasserian ganglion, a hitherto unreported site, that extended infratentorially to present as a cerebellopontine angle tumor is reported. It is important to recognize that cellular schwannomas can histologically mimic malignant peripheral nerve sheath tumors because of their high cellularity and mitotic activity, but they are relatively benign tumors with a tendency to recur but not metastasize.
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