Isolated trigeminal nerve sarcoid granuloma mimicking trigeminal XXXX : case report.

@entity808 @entity1 @entity1183 @entity738 @entity4254 @entity1109 @entity3292 @entity425 @entity74 @entity158 @entity370 @entity2049
OBJECTIVE AND IMPORTANCE: Sarcoidosis most commonly presents as a @entity74 . Infrequently, @entity370 can manifest itself in the central nervous system, with @entity738 involving the leptomeninges and presenting with @entity425 . Sarcoid of the trigeminal nerve is exceedingly rare and can mimic trigeminal @entity808 . We review the literature on sarcoid @entity738 of the trigeminal nerve and compare their radiological features with the more common @entity808 . CLINICAL PRESENTATION: A 33-year-old @entity1 presented with a history of left-sided @entity158 and @entity1183 for 11 months, which was presumed to be @entity4254 . A trial of @entity2049 had been unsuccessful in relieving the @entity158 . Her neurological examination revealed @entity1109 in the V(1)-V(2) distribution. Preoperative magnetic resonance imaging demonstrated a contrast-enhancing mass centered in the left cavernous sinus with extension along the cisternal portion of the left trigeminal nerve. INTERVENTION: The @entity1 underwent a left frontotemporal orbitozygomatic craniotomy with intraoperative neurophysiological monitoring of Cranial Nerves III, V, and VI and image guidance for subtotal microsurgical resection of what appeared, grossly and on frozen section, to be a @entity3292 . The final pathology report, however, revealed a sarcoid granuloma of the trigeminal nerve. CONCLUSION: The differential diagnosis of contrast-enhancing lesions in the lateral wall of the cavernous sinus should include inflammatory conditions such as @entity370 . We recommend that surgery for biopsy or decompression be used only for those @entity1 in whom a diagnosis cannot be confirmed with noninvasive testing. If surgery is performed, intraoperative frozen pathology is very useful in guiding the extent of resection.
