title: Central nervous system lymphoma presenting as trigeminal neuralgia: A diagnostic challenge.
abstract: We describe an atypical man with diffuse large B cell lymphoma localized to the sphenoid wing and adjacent cavernous sinus, initially presenting with isolated ipsilateral facial pain mimicking trigeminal neuralgia due to invasion of Meckel's cave but subsequently progressing to intra-axial extension and having synchronous features of systemic lymphoma. Primary central nervous system lymphoma is uncommon, accounting for approximately 2% of all primary intracranial tumors, but its incidence has been steadily increasing in some groups [1]. It usually arises in the periventricular cerebral white matter, and reports of lymphoma in extra-axial regions are rare [2]. This man highlights the importance of maintaining lymphoma in the differential diagnosis of tumors of the skull base presenting with trigeminal neuralgia-like symptoms.
authors: College of Medicine and Veterinary Medicine, University of Edinburgh, Midlothian, UK.
authors: Jensen W J
authors: JW
authors: Ang
authors: Department of Neurosurgery, Massachusetts General Hospital, 55 Fruit Street, WACC 745, Boston, MA 02115, USA; Harvard Medical School, Boston, MA, USA.
authors: Arjun
authors: A
authors: Khanna
authors: Department of Neurosurgery, Massachusetts General Hospital, 55 Fruit Street, WACC 745, Boston, MA 02115, USA; Harvard Medical School, Boston, MA, USA. Electronic address: walcott.brian@mgh.harvard.edu.
authors: Brian P
authors: BP
authors: Walcott
authors: Department of Neurosurgery, Massachusetts General Hospital, 55 Fruit Street, WACC 745, Boston, MA 02115, USA; Harvard Medical School, Boston, MA, USA.
authors: Kristopher T
authors: KT
authors: Kahle
authors: Department of Neurosurgery, Massachusetts General Hospital, 55 Fruit Street, WACC 745, Boston, MA 02115, USA; Harvard Medical School, Boston, MA, USA.
authors: Emad N
authors: EN
authors: Eskandar
mesh_terms: D002426:Cavernous Sinus / Q000473:pathology; D003399:Craniotomy / Q000379:methods; D003937:Diagnosis, Differential; D006801:Humans; D016403:Lymphoma, Large B-Cell, Diffuse / Q000150:complications / Q000175:diagnosis*; D008297:Male; D008875:Middle Aged; D019635:Neurosurgical Procedures / Q000379:methods; D010146:Pain / Q000209:etiology; D019051:Rhizotomy / Q000379:methods; D019292:Skull Base Neoplasms / Q000150:complications / Q000175:diagnosis*; D013101:Sphenoid Sinus / Q000473:pathology; D016896:Treatment Outcome; D014277:Trigeminal Neuralgia / Q000175:diagnosis* / Q000209:etiology
keywords: Lymphoma; Skull base; Trigeminal neuralgia