A case of trigeminal malignant melanotic nerve sheath tumor in the wide spectrum of melanotic and nerve sheath tumors

• Author(s): Rachão, Augusto ; Ferro, Margarida ; Roque, Rafael ; Rainha Campos, Alexandre ; Pimentel, José
• Date: 2023
• Persistent ID: http://hdl.handle.net/10451/55902
• Origin: Repositório da Universidade de Lisboa
• Document Type: Journal article
• Language: English
• Contributor(s): Repositório Científico de Acesso Aberto da ULisboa

Description

We report the case of a 42-year-old male, without any other personal or familiar relevant background, who was referred to a neurosurgery outpatient clinic due to a yearlong altered right facial sensitivity with paresthesia. Facial hypoesthesia in V1 and V2 divisions of the right trigeminal nerve was noticed. No other deficits were evidenced, and the remaining objective examination was unremarkable, namely for cutaneous lesions. Brain magnetic resonance imaging (MRI) displayed a space-occupying lesion in the right cavernous sinus, suggestive of a melanin-rich lesion. Three months later, the patient reported right facial hypoesthesia extending to V3, along with chewing difficulties lateralized to the right. A new MRI showed lesion growth toward Meckel’s cavum and the path of the right trigeminal nerve, and the patient was referred to neurosurgery. Using a subtemporal, extradural approach, a lesion with black coloration that was confined to Meckel’s cavum between trigeminal fascicles was nearly completely removed. The posterior fossa extent was also removed after all of the Meckel’s cavum portion was decompressed.