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J 'EFFERSON, in a recent review of the literature and report of his own eases, analyzed 3~ instances of trigeminal neurofibromas. Baker and Bailey, Cushing and Eisenhardt, Gonzalez Revilla, Loew and TSnnis, and Davidoff and Epstein also have reported another 11 eases, so that the total number thus far reported is 43.1-19,~1-24,~6-2s PRESENT STUDYIn this communication we are reviewing 13 eases in which solitary neurofibromas (neurilemmomas) of the fifth cranial nerve were encountered at the Mayo Clinic. We have excluded all eases of von Reeklinghausen's disease.For purposes of this study, the eases were divided into three groups morphologically, according to whether the lesions arose mainly in the middle cranial fossa, subtentorially in the posterior fossa, or in both situations in more or less equal extent. However, some of the tumors that presented in either the middle or posterior fossa also had extended slightly into the other fossa.Jefferson found that in the 3~ cases he reviewed, 15 lesions were mainly or entirely tumors of the middle fossa, 11 were situated in the posterior fossa and 6 were tumors of both the middle and posterior fossas. In our series, 6 lesions were restricted primarily, if not entirely, to the middle fossa, 4 were essentially limited to the posterior fossa and 3 were both supratentorial and infratentorial.We found that very often it is difficult to make an early diagnosis of this kind of tumor. In our series, some change in the cutaneous sensibility of the face constituted an early finding in only 6 instances, and in ~ patients symptoms and signs of involvement of the fifth nerve were absent. In only 4 eases was pain present in the distribution of the fifth nerve, and this pain was not tic-like, although it was periodic in one instance. In another case the pain extended from the region of the ear into the paratracheal and inferior mandibular region and it was also periodic.

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