[Trigeminal neuralgia presenting as a deep recurrent desmoplastic neurotropic melanoma of a lentigo maligna].
BACKGROUND
Neurotropic melanoma is a particular anatomopathological form corresponding to dermal proliferation of desmoplastic cells of neuroid differentiation. We report a new case of neurotropic melanoma revealed by facial neuralgia.


METHODS
A 64 year-old man presented in 1996 with a lentigo maligna on the right cheek treated by complete excision. After 2 years of medical supervision, a pigmented lesion recurred leading to new surgical treatment. The histological examination of the total lesion showed intra-epidermal atypical melanocyte proliferation without dermal invasion. In 1999, right trigeminal neuralgia occurred without associated cutaneous change. Cranial MRI revealed an infiltration of the right trigeminal nerve. Endo-buccal surgery disclosed a black swelling of the trigeminal nerve. Histological examination and immunohistochemistry revealed a desmoplastic melanoma.


CONCLUSIONS
Neurotropic melanoma with nerve invasion by malignant cells presenting as a trigeminal neuralgia is rare. Our case report underlined the depth of the neurotropic melanoma and the initial existence of a lentigo maligna without associated "neurotropic" melanoma.
Fabre
B
B
Service de Dermatologie, Hôpital La Grave, Toulouse.
Gigaud
M
M
Lamant
L
L
Boulinguez
S
S
Viraben
R
R
D003390:Cranial Nerve Neoplasms / Q000150:complications* / Q000556:secondary; D005156:Facial Neuralgia / Q000209:etiology*; D006801:Humans; D018327:Hutchinson's Melanotic Freckle / Q000150:complications* / Q000473:pathology / Q000556:secondary; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000150:complications* / Q000473:pathology; D012878:Skin Neoplasms / Q000150:complications* / Q000473:pathology; D020433:Trigeminal Nerve Diseases / Q000209:etiology; D014277:Trigeminal Neuralgia / Q000209:etiology*