Trigeminal amyloidoma: case report and review of the literature.

Journal Article

The authors present a case of amyloid infiltration involving the trigeminal nerve that mimicked a malignant cavernous sinus tumor with perineural tumor infiltration. A 64-year-old man presented with trigeminal nerve numbness. Imaging revealed a plaque-like enhancing lesion along the right lateral cavernous sinus extending anteriorly into Meckel's cave and involving the proximal V2 and V3 branches of the trigeminal nerve. The patient underwent an extradural frontotemporal craniotomy with middle fossa exposure of the cavernous sinus to diagnose and treat the presumed malignant cavernous sinus tumor. A reddish mass involving the lateral dural wall of the cavernous sinus was resected. The gasserian ganglion, V2, and V3, the latter of which was biopsied, were enlarged. Permanent histopathological studies showed microscopic eosinophilic, amorphous material, which stained positive for Congo red, and an absence of neoplastic cells. The final diagnosis was amyloidoma. Thus, amyloidomas can involve the trigeminal nerve or ganglia and should be considered in the differential diagnosis of a cavernous sinus lesion mimicking a tumor. Patients may have symptomatic improvement of trigeminal neuropathy with resection of the amyloidoma outside the nerve capsule that is compressing the nerve, while resection of the lesion from within the capsule may result in permanent trigeminal nerve dysfunction.

Full Text

Duke Authors

Cited Authors

  • Gottfried, ON; Chin, S; Davidson, HC; Couldwell, WT

Published Date

  • September 2007

Published In

Volume / Issue

  • 17 / 5

Start / End Page

  • 317 - 324

PubMed ID

  • 18330430

International Standard Serial Number (ISSN)

  • 1531-5010

Digital Object Identifier (DOI)

  • 10.1055/s-2007-986430

Language

  • eng

Conference Location

  • United States