Isolated Lympho-histiocytic Inflammation of the Gasserian Ganglion Mimicking Trigeminal Schwannoma

Abstract

We present an unusual case of a patient with trigeminal pain and hypesthesia suggesting trigeminal schwannoma, where histology demonstrated an inflammatory lesion of the Gasserian ganglion.

Clinical presentation: Patient history and imaging were typical for a trigeminal schwannoma with a dumbbell growth in the middle and posterior fossa. Surgery was performed and resection of a firm mass intermingled with fascicles originating from the ganglion and the mandibular branch was carried out via a subtemporal approach. Histological diagnosis revealed a non-caseating, vaguely granulomatous lymphocyte- and histiocyte-rich inflammation.

Conclusion: Inflammatory lesions of the Gasserian ganglion are rare but may mimic tumors. Intraoperative biopsies should be taken prior to complete resection to limit neurological deterioration.

Key words

lympho-histiocytosis - trigeminal - schwannoma - neurosarcoidosis

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