ABSTRACT
Abstract Trigeminal trophic syndrome is an uncommon cause of facial ulcers, that affects the sensitive area of the trigeminal nerve. We present the case of an 84-year-old patient with ulcerated facial trigeminal trophic syndrome, and report the development of a clinico-dermoscopic approach for his clinical examination. The value of this model for the diagnosis of facial ulcers suspected to be a rodent ulcer basal cell carcinoma is suggested.
Subject(s)
Humans , Animals , Male , Aged, 80 and over , Skin Neoplasms/pathology , Skin Ulcer/pathology , Carcinoma, Basal Cell/pathology , Trigeminal Nerve Diseases/pathology , Facial Dermatoses/pathology , Syndrome , Magnetic Resonance Imaging , Dermoscopy , Diagnosis, DifferentialABSTRACT
In most cases, while schwannoma is sporadically manifested as a single benign neoplasm, the presence of multiple schwannomas in one patient is usually indicative of neurofibromatosis 2. However, several recent reports have suggested that schwannomatosis itself may also be a distinct clinical entity. This study examines an extremely rare case of probable schwannomatosis associated with intracranial, intraspinal and peripheral involvements. A 63-year-old woman presented with a seven-year history of palpable lumps on both sides of the supraclavicular area and hearing impairment in both ears. On physical examination, no skin manifestations were evident. Facial sensory change, deafness in the left ear and decreased gag reflex were revealed by neurological examination. Magnetic resonance imaging revealed multiple lesions of the trigeminal nerves, acoustic nerves, lower cranial nerves, spinal accessory nerve, brachial plexuses, and spinal nerves. Pathological examination of tumors from the bilateral brachial plexuses, the spinal nerve in the T8 spinal position and the neck mass revealed benign schwannomas. Following is this patient case report of multiple schwannomas presenting with no skin manifestations of neurofibromatosis.
Subject(s)
Female , Humans , Brachial Plexus Neuropathies/pathology , Cranial Nerve Neoplasms/pathology , Magnetic Resonance Imaging , Middle Aged , Neurilemmoma/pathology , Neurofibromatoses/pathology , Spinal Canal/pathology , Trigeminal Nerve Diseases/pathology , Vestibulocochlear Nerve Diseases/pathologyABSTRACT
Lesions in the parasellar and paracavernous regions can be removed by various skull base approaches involving basal osteotomies. A major complication of intradural skull base approaches is CSF leak and associated meningitis. We have managed 5 patients with skull base lesions with a pure extradural approach using wide basal osteotomies. The operative techniques are described.