Meckel Cave Epidermoid Cyst Presenting as Multiple Cranial Nerve Deficits Due to Indirect Tumoral Compression of the Cavernous Sinus: A Case Report and Literature Review

Büsch, Christopher; Prickett, Joshua; Stein, Rachel; Cuoco, Joshua A.; Marvin, Eric A.; Witcher, Mark R.

doi:10.1016/j.wneu.2018.09.206

Cited by 13 publications

(10 citation statements)

References 15 publications

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“…As she did not have hemiplegia, facial nerve palsy, deafness, nausea, and vomiting, a lesion in the course of nerve distal to the pontine exit becomes a possibility, further localizing it to the region of the cavernous sinus or its adjacent structures. [ 3 6 7 8 ] This is explained in Figure 2 . [ 4 9 ]…”

Section: Case Detailsmentioning

confidence: 99%

“…Meckel's cave is a narrow complex space measuring 4 mm × 7.5 mm, situated inferolateral to the posterior part of the cavernous sinus [ Figure 3 ]. [ 3 6 7 ] Structures within the lateral wall of the compartment of the cavernous sinus, from superior to inferior include the oculomotor nerve, trochlear nerve, ophthalmic, and maxillary branches of the trigeminal nerve. Structures passing through the medial wall are the abducent nerve, internal carotid artery and associated carotid plexus.…”

Section: Case Detailsmentioning

confidence: 99%

“…It is situated between the prepontine cistern and the cavernous sinus, housing the trigeminal ganglion, and the proximal rootlets of the trigeminal nerve. [ 1 2 3 ] Compression of structures around the Meckel's cave results in a classical picture which can be clinically localized. [ 3 ] We report a middle-aged lady who presented with unilateral temporal headache and was subsequently diagnosed to have Meckel's cave meningioma confirmed by imaging.…”

Section: Introductionmentioning

confidence: 99%

“…[ 1 2 3 ] Compression of structures around the Meckel's cave results in a classical picture which can be clinically localized. [ 3 ] We report a middle-aged lady who presented with unilateral temporal headache and was subsequently diagnosed to have Meckel's cave meningioma confirmed by imaging. We present an algorithmic approach to localize the lesion to the Meckel's cave at the bedside.…”

Section: Introductionmentioning

confidence: 99%

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Unraveling a cephalalgic quagmire from a cavern to a cave

Thenmozhi

Girija

Viswanathan

et al. 2021

Journal of Postgraduate Medicine

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Headache in women in their late forties can be primary or secondary. We report a 48-year-old female with chronic slowly progressive left temporal headache for 1 year. She also had ipsilateral eye pain and facial numbness for 1 month, with restricted abduction in the left eye and diplopia. On neurological examination, she had isolated left abducent nerve palsy, with loss of corneal and conjunctival reflexes, localizing the pathology to the cavernous sinus or its adjacent structures. Anatomically, cranial nerves V and VI are in close proximity to each other in the region of Meckel's cave. In view of her age, insidious onset, progressive symptoms and clinical findings, the provisional diagnosis in this patient was a Meckel's cave tumor. Magnetic resonance (MR) imaging revealed a 2 cm × 2 cm × 1.7 cm enhancing dumb-bell-shaped mass lesion with mild restricted diffusion in the Meckel's cave projecting into cavernous sinus with alanine, myoinositol and glutamine peaks on MR spectroscopy. Intradural debulking was done; lesion was confirmed by histopathology and patient was cured of her symptoms. An algorithm for diagnosing this entity at the bedside is presented.

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Section: Case Detailsmentioning

confidence: 99%

Section: Case Detailsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Unraveling a cephalalgic quagmire from a cavern to a cave

Thenmozhi

Girija

Viswanathan

et al. 2021

Journal of Postgraduate Medicine

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“…Intracranial epidermoid cysts (ECs), also known as cholesteatomas, are rare benign, slow-growing lesions that account for 0.2–1.8% of intracranial tumors (1). Although classified as a benign entity based on histopathology and potentially curable with neurosurgical gross total resection, ECs can rarely undergo malignant transformation (MT) into squamous cell carcinoma (SCC).…”

Section: Introductionmentioning

confidence: 99%

Intracranial Squamous Cell Carcinoma Arising From a Cerebellopontine Angle Epidermoid Cyst Remnant Four Decades After Partial Resection

et al. 2019

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Intracranial epidermoid cysts are benign lesions that typically remain asymptomatic; however, although histopathologically benign, these cysts can rarely undergo malignant transformation into squamous cell carcinoma. Primary intracranial squamous cell carcinoma carries a poor prognosis as optimal treatment modalities remain unclear due to their low incidence. Here, we present a case of a cerebellopontine angle epidermoid cyst remnant that underwent malignant transformation into squamous cell carcinoma 40 years after partial resection. To our knowledge, this case establishes the longest time interval to date for an intracranial epidermoid cyst to undergo malignant transformation. We also review the relevant literature and discuss recent retrospective clinical studies that have analyzed the effect of multimodal treatment approaches on survival outcomes in patients with these lesions.

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Cerebellopontine Angle Epidermoid Tumors

Refaee

Schroeder

2022

Contemporary Skull Base Surgery

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Meckel Cave Epidermoid Cyst Presenting as Multiple Cranial Nerve Deficits Due to Indirect Tumoral Compression of the Cavernous Sinus: A Case Report and Literature Review

Cited by 13 publications

References 15 publications

Unraveling a cephalalgic quagmire from a cavern to a cave

Unraveling a cephalalgic quagmire from a cavern to a cave

Intracranial Squamous Cell Carcinoma Arising From a Cerebellopontine Angle Epidermoid Cyst Remnant Four Decades After Partial Resection

Cerebellopontine Angle Epidermoid Tumors

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