Rinsho Shinkeigaku (Clinical Neurology)

Brief Clinical Note

Malignant lymphoma in a perineural spreading along trigeminal nerve, which developed as trigeminal neuralgia

Tomoo Mano, M.D., Ph.D.1)2), Koji Matsuo, M.D.1), Yosuke Kobayashi, M.D., Ph.D.1), Yasushi Kobayashi, M.D., Ph.D.1), Hiroaki Ozawa, M.D.3) and Toshinao Arakawa, M.D.4)

1)Department of Neurology, Okazaki City Hospital
2)Department of Neurology, Nagoya University Graduate School of Medicine
3)Department of Pathology, Okazaki City Hospital
4)Department of Radiology, Okazaki City Hospital

A rare cause of trigeminal neuralgia is malignant lymphoma which spread along the trigeminal nerve. We report a 79-year-old male presented with 4-month history of neuralgic pain in right cheek. He was diagnosed as classical trigeminal neuralgia. It had improved through medication of carbamazepine. Four months later, the dull pain unlike neuralgia complicated on the right cheeks, it was ineffective with the medication. Furthermore, diplopia and facial palsy as the other cranial nerve symptoms appeared. Gadolinium-enhanced magnetic resonance imaging (MRI) revealed contrastenhanced mass lesion extend both external pterygoid muscle and brainstem through the swelling trigeminal nerve. The patient was pathological diagnosed of diffuse large B cell lymphoma by biopsy. Malignant lymphoma should be considered in the different diagnosis of cases with a minimal single cranial nerve symptom.
Full Text of this Article in Japanese PDF (6204K)

(CLINICA NEUROL, 54: 660|663, 2014)
key words: malignant lymphoma, trigeminal nerve, perineural tumor

(Received: 1-Oct-13)