Turkish Neurosurgery
Deceptive Mimics of Trigeminal Schwannoma: Be Careful with Primary Radiosurgery |
Sripartha Krishna Yerramilli1, Manjul Tripathi 1, Chirag K Ahuja2, Sandeep Mohindra1, Rajeev Chauhan3 |
1PGIMER, Chandigarh, Neurosurgery, Chandigarh, 2PGIMER, Chandigarh, Radiology, Chandigarh, 3PGIMER CHANDIGARH, NEUROANESTHESIA, CHANDIGARH, |
DOI: 10.5137/1019-5149.JTN.45077-23.2 |
Introduction
Trigeminal schwannomas are rare lesions centered on the trigeminal ganglion at Meckel\'s cave. The complexity and morbidity of surgery for these lesions have allowed stereotactic radiosurgery (SRS) to emerge as a safe and viable option for treatment. Various other lesions at this location must alert one to consider an alternative diagnosis before upfront SRS without histopathological correlation.
Methods and Results
We present three patients with trigeminal neuropathy with imaging suggesting trigeminal schwannoma. Primary clinicians recommended primary radiosurgery to these patients based on radiological diagnosis. Upon further evaluation and clinical suspicion, we established alternate diagnoses of non-Hodgkin\'s lymphoma, lepromatous trigeminal nerve involvement, and Aspergillosis involving the Meckel\'s cave in three cases. Each patient received appropriate treatment instead of SRS.
Conclusion
SRS is one of the treatment options for trigeminal schwannoma. No neurosurgical ailment should be treated on its face value with primary SRS, but it must be carefully evaluated on a clinicoradiological profile. Upfront, primary SRS may be counterproductive or detrimental for inflammatory or infectious pathologies, attracting complications.
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Corresponding author : Manjul Tripathi