Intracranial neoplastic lesions of the trigeminal nerve: How MRI can help

Donia, Mohamed Mahmoud; Gamaleldin, Omneya; Abdo, Ashraf; Desouky, Salah El-Din; Helmy, Shadia

doi:10.1016/j.ejrnm.2017.07.008

Cited by 5 publications

(5 citation statements)

References 28 publications

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“…It is widely dispersed throughout the face and is in charge of the face's primary sensory supply. TN can be caused by a variety of benign and malignant neoplasm tumours [9].…”

Section: Discussionmentioning

confidence: 99%

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Magnetic Resonance Imaging in Trigeminal Neuralgia

Elakhder

Teima²,

Mohamed³

et al. 2022

JAMMR

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Background: Trigeminal neuralgia (TN) is still a serious neurologic condition that causes significant facial pain that is unilateral and is distributed across the trigeminal nerve. Magnetic resonance imaging (MRI) is an excellent imaging technique for determining the aetiology of TN, despite the fact that there are no particular clinical tests for its diagnosis. 3D FIESTA MRI helps to improve diagnostic precision and identify neurovascular compression when used in conjunction with conventional MRI. MRI is used to rule out alternative causes of TN, such as cerebellopontine angle lesions, demyelinating diseases, and inflammatory conditions, in addition to neurovascular compression. Aim of the Work: The objective of this study was to assess the utility of MRI in the diagnosis of TN and its various causes. Patients and Methods: In this prospective study, 30 patients (14 men and 16 women), with an average age of 49.6 years, were referred to Tanta University Hospital's Radiodiagnosis and Medical Imaging Department from outpatient neurosurgery and/or dental clinics. Results: The commonest affected side was the left side (46.7%) followed by the right one (40%), while bilateral affection was seen in (13.3%) of cases. According to aetiological factor, TN was secondary to underlying pathology in 24 cases (80%), while idiopathic TN with no underlying pathology was found in 6 cases (20%). Neurovascular compression and neoplastic lesions had the higher incidence. The most affected segment of the trigeminal nerve was the cisternal segment that was involved in 15 cases out of 24 cases with abnormal MRI findings. Conclusion: Many CPA lesions may cause TN such as schwannomas and meningiomas. Demyelinating disease as multiple sclerosis were reported in our study to cause also TN. MRI showed that it has significant diagnostic role denoting brain lesions in patients with TN as it has a diagnostic accuracy 62.5%, sensitivity 60% and specificity 100% (P < 0.001).

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“…It is widely dispersed throughout the face and is in charge of the face's primary sensory supply. TN can be caused by a variety of benign and malignant neoplasm tumours [9].…”

Section: Discussionmentioning

confidence: 99%

“…Clinicians have conducted a variety of studies to categorise atypical facial aches in order to give a framework with which to establish an accurate diagnosis and to adequately advise on treatment options and prognosis [9]. One of the most unpleasant types of facial discomfort is TN.…”

Section: Discussionmentioning

confidence: 99%

Magnetic Resonance Imaging in Trigeminal Neuralgia

Elakhder

Teima²,

Mohamed³

et al. 2022

JAMMR

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“…This structure contains the Gasserian ganglion of the trigeminal nerve as well as the three postganglionic trigeminal roots: ophthalmic (V1), maxillary (V2), and mandibular (V3) [5]. Tumors in Meckel's cave are uncommon but the most frequent neoplasms at this site include trigeminal nerve sheath tumors, schwannomas, meningiomas, neurofibromas, nasopharyngeal carcinoma, and leptomeningeal metastases from solid organ malignancy (renal cell, lung, and breast) [4][5][6][7]. Metastatic lymphoma involving Meckel's cave is rare with as few as 11 previously reported cases [8].…”

Section: Discussionmentioning

confidence: 99%

“…1a). The differential diagnosis for infiltrative process in Meckel's cave included sarcoidosis as well as primary or secondary neoplastic lesions such as meningioma, nasopharyngeal carcinoma, schwannoma, neurofibroma, and lymphoma [4,5]. The presence of constitutional symptoms and elevated inflammatory markers suggested a secondary process with associated intracranial involvement.…”

Section: Case Descriptionmentioning

confidence: 99%

Diffuse large B cell lymphoma involving Meckel’s cave masquerading as biopsy-negative giant cell arteritis: a case report

et al. 2020

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Background: Given the absence of consensus diagnostic criteria for giant cell arteritis, clinicians may encounter difficulty with identification of new-onset headache in patients older than age 50 years presenting with visual changes and elevated inflammatory markers, particularly if temporal artery biopsies are performed and negative. Case presentation: We present a case of a 57-year-old white man with headache, diplopia, and jaw paresthesia initially diagnosed and managed as steroid-refractory biopsy-negative giant cell arteritis. Further investigation disclosed evidence of soft tissue infiltration into Meckel's (trigeminal) cave bilaterally. Positron emission tomography suggested the presence of a lymphoproliferative disorder. Histology confirmed the diagnosis of diffuse large B cell lymphoma. Conclusions: Metastatic involvement in Meckel's cave in diffuse large B cell lymphoma is extremely rare and presents a diagnostic challenge. Patients with suspicion of giant cell arteritis should undergo advanced imaging, particularly those with negative biopsy, atypical features, or lack of response to standard therapy, in order to assess for the presence of large-vessel vasculitis or other mimicking pathologies.

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“…In addition, an eligible study was added following conducting a new search on 8 September 2022. Finally, 12 studies [24][25][26][27][28][29][30][31][32][33][34][35] were included in the meta-analysis, consisting of 181 lymphoma and 449 NPC lesions (N = 630) in the head and neck region (Figure 1).…”

Section: Literature Searchmentioning

confidence: 99%

Differentiating nasopharyngeal carcinoma from lymphoma in the head and neck region using the apparent diffusion coefficient (ADC) value: a systematic review and meta-analysis

Tabnak,

HajiEsmailPoor

2023

Pol J Radiol

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PurposeThis study aimed to assess the applicability of the apparent diffusion coefficient (ADC) for differentiating nasopharyngeal carcinoma (NPC) from lymphomas in the head and neck region.Material and methodsFour databases, including PubMed, the Cochrane Library, EMBASE, and Web of Science, were searched systematically to find relevant literature. The search date was updated to 8 September 2022, with no starting time restriction. The methodological quality of the studies was evaluated using the Quality Assessment of Diagnostic Accuracy Studies-2 tool. Firstly, a random-effects model was used in a meta-analysis of continuous variables with low heterogeneity to determine the overall effect size, which was reported as the standard mean difference (SMD). Then, bivariate random effects modelling was used to calculate the combined sensitivity and specificity. The area under the curve (AUC) for each diffusion parameter was calculated after constructing summary receiver operating characteristic curves. The presence of heterogeneity was evaluated using subgroup and meta-regression analysis.ResultsTwelve studies involving 181 lymphoma and 449 NPC lesions (<i>N</i> = 630) in the head and neck region were included, of which 5 studies provided sufficient data for pooling diagnostic test accuracy. A meta-analysis of the 12 studies using a random-effects model yielded an SMD of 1.03 (CI = 0.76-1.30; <i>p</i> = 0.00001), implying that NPC lesions had a significantly higher ADC value than lymphoma lesions. By pooling 5 standard DWI studies, the pooled sensitivity and specificity of ADC were 0.90 (95% CI: 0.82-0.95) and 0.63 (95% CI: 0.52-0.72), respectively. The area under the curve (AUC) calculated from the SROC curve was 0.74 (95% CI: 0.70-0.78).ConclusionsAccording to this systematic review and meta-analysis, nasopharyngeal carcinoma has a significantly higher ADC value than lymphomas. Furthermore, while ADC has excellent sensitivity for distinguishing these 2 types of tumours, its specificity is relatively low, yielding a moderate diagnostic performance. Further investigations with larger sample sizes are required.

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Intracranial neoplastic lesions of the trigeminal nerve: How MRI can help

Cited by 5 publications

References 28 publications

Magnetic Resonance Imaging in Trigeminal Neuralgia

Magnetic Resonance Imaging in Trigeminal Neuralgia

Diffuse large B cell lymphoma involving Meckel’s cave masquerading as biopsy-negative giant cell arteritis: a case report

Differentiating nasopharyngeal carcinoma from lymphoma in the head and neck region using the apparent diffusion coefficient (ADC) value: a systematic review and meta-analysis

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