An intracranial odyssey: pediatric ganglioneuroma arising from the trigeminal ganglion: a case report and review of the literature

Abstract Background Ganglioneuroma represents an uncommon benign tumor arising from the sympathetic nerves, and its development from the fifth nerve is an infrequent entity. Few ganglioneuromas arising from the fifth nerve have been discussed in literature. The authors describe the second pediatric...

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Main Authors: Kaveh Ebrahimzadeh, Mohammad Mirahmadi Eraghi, Farahnaz Bidari Zerehpoosh, Hesameddin Hoseini Tavasol, Mahkameh Abbaszdeh, Adam A. Dmytriw, Fatemeh Jahanshahi
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Language:English
Published: BMC 2024-12-01
Series:Journal of Medical Case Reports
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Online Access:https://doi.org/10.1186/s13256-024-04947-9
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author Kaveh Ebrahimzadeh
Mohammad Mirahmadi Eraghi
Farahnaz Bidari Zerehpoosh
Hesameddin Hoseini Tavasol
Mahkameh Abbaszdeh
Adam A. Dmytriw
Fatemeh Jahanshahi
author_facet Kaveh Ebrahimzadeh
Mohammad Mirahmadi Eraghi
Farahnaz Bidari Zerehpoosh
Hesameddin Hoseini Tavasol
Mahkameh Abbaszdeh
Adam A. Dmytriw
Fatemeh Jahanshahi
author_sort Kaveh Ebrahimzadeh
collection DOAJ
description Abstract Background Ganglioneuroma represents an uncommon benign tumor arising from the sympathetic nerves, and its development from the fifth nerve is an infrequent entity. Few ganglioneuromas arising from the fifth nerve have been discussed in literature. The authors describe the second pediatric ganglioneuroma arising from the fifth nerve. Case presentation A 7 year-old Asian male suffering from left-sided facial paresthesia, accompanied by several episodes of complex seizures over the past 2 years, presented to our clinic. The patient also complained of sudden unconsciousness and concurrent upward gaze lasting less than a minute. A brain computed tomography scan and magnetic resonance imaging revealed an isodense lesion containing focal calcifications measuring 31 × 28 mm and a solid mass extending from the pontine surface to Meckel’s cave, probably originating from the fifth nerve or its root entry zone. The lesion was mildly hypointense on T1-weighted sequences and hyperintense on T2-weighted and fluid attenuated inversion recovery sequences. Gadolinium injection revealed only minimal heterogeneous enhancement. Histopathologic and immunohistochemical findings were consistent with ganglioneuroma. A lateral approach via retrosigmoid incision and suboccipital lateral craniectomy toward the cerebellopontine angle was performed under neuromonitoring supervision, and the postoperative period was uneventful. Conclusion Although ganglioneuroma arising from the fifth nerve is an extremely rare entity, it should be considered when diagnosing lesions in Meckel’s cave or the cerebellopontine angle cistern.
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spelling doaj-art-c1499d0cecf64f0ba50d0b751d0a2cb82024-12-22T12:27:54ZengBMCJournal of Medical Case Reports1752-19472024-12-011811810.1186/s13256-024-04947-9An intracranial odyssey: pediatric ganglioneuroma arising from the trigeminal ganglion: a case report and review of the literatureKaveh Ebrahimzadeh0Mohammad Mirahmadi Eraghi1Farahnaz Bidari Zerehpoosh2Hesameddin Hoseini Tavasol3Mahkameh Abbaszdeh4Adam A. Dmytriw5Fatemeh Jahanshahi6Skull Base Research Center, Loghman-e Hakim Hospital, Shahid Beheshti University of Medical SciencesSkull Base Research Center, Loghman-e Hakim Hospital, Shahid Beheshti University of Medical SciencesDepartment of Pathology, Loghman-E-Hakim Hospital, Shahid Beheshti University of Medical SciencesSkull Base Research Center, Loghman-e Hakim Hospital, Shahid Beheshti University of Medical SciencesSkull Base Research Center, Loghman-e Hakim Hospital, Shahid Beheshti University of Medical SciencesSkull Base Research Center, Loghman-e Hakim Hospital, Shahid Beheshti University of Medical SciencesResearch Committee Member, Faculty of Medicine, Iran University of Medical SciencesAbstract Background Ganglioneuroma represents an uncommon benign tumor arising from the sympathetic nerves, and its development from the fifth nerve is an infrequent entity. Few ganglioneuromas arising from the fifth nerve have been discussed in literature. The authors describe the second pediatric ganglioneuroma arising from the fifth nerve. Case presentation A 7 year-old Asian male suffering from left-sided facial paresthesia, accompanied by several episodes of complex seizures over the past 2 years, presented to our clinic. The patient also complained of sudden unconsciousness and concurrent upward gaze lasting less than a minute. A brain computed tomography scan and magnetic resonance imaging revealed an isodense lesion containing focal calcifications measuring 31 × 28 mm and a solid mass extending from the pontine surface to Meckel’s cave, probably originating from the fifth nerve or its root entry zone. The lesion was mildly hypointense on T1-weighted sequences and hyperintense on T2-weighted and fluid attenuated inversion recovery sequences. Gadolinium injection revealed only minimal heterogeneous enhancement. Histopathologic and immunohistochemical findings were consistent with ganglioneuroma. A lateral approach via retrosigmoid incision and suboccipital lateral craniectomy toward the cerebellopontine angle was performed under neuromonitoring supervision, and the postoperative period was uneventful. Conclusion Although ganglioneuroma arising from the fifth nerve is an extremely rare entity, it should be considered when diagnosing lesions in Meckel’s cave or the cerebellopontine angle cistern.https://doi.org/10.1186/s13256-024-04947-9GanglioneuromaTrigeminal nerveFifth cranial nerveBrain stem
spellingShingle Kaveh Ebrahimzadeh
Mohammad Mirahmadi Eraghi
Farahnaz Bidari Zerehpoosh
Hesameddin Hoseini Tavasol
Mahkameh Abbaszdeh
Adam A. Dmytriw
Fatemeh Jahanshahi
An intracranial odyssey: pediatric ganglioneuroma arising from the trigeminal ganglion: a case report and review of the literature
Journal of Medical Case Reports
Ganglioneuroma
Trigeminal nerve
Fifth cranial nerve
Brain stem
title An intracranial odyssey: pediatric ganglioneuroma arising from the trigeminal ganglion: a case report and review of the literature
title_full An intracranial odyssey: pediatric ganglioneuroma arising from the trigeminal ganglion: a case report and review of the literature
title_fullStr An intracranial odyssey: pediatric ganglioneuroma arising from the trigeminal ganglion: a case report and review of the literature
title_full_unstemmed An intracranial odyssey: pediatric ganglioneuroma arising from the trigeminal ganglion: a case report and review of the literature
title_short An intracranial odyssey: pediatric ganglioneuroma arising from the trigeminal ganglion: a case report and review of the literature
title_sort intracranial odyssey pediatric ganglioneuroma arising from the trigeminal ganglion a case report and review of the literature
topic Ganglioneuroma
Trigeminal nerve
Fifth cranial nerve
Brain stem
url https://doi.org/10.1186/s13256-024-04947-9
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