• Hua Zhao, Ding-Zhong Tang, Jin Zhu, Xin Zhang, Yin-da Tang, and Shi-Ting Li.
• Department of Neurosurgery, Xinhua Hospital Affiliated with Shanghai Jiaotong University School of Medicine, Shanghai, China.
• World Neurosurg. 2019 Mar 1; 123: 383-389.

BackgroundExtraaxial lymphoma involving the trigeminal nerve, an uncommon condition that presents as a trigeminal schwannoma, resulted in misdiagnosis and a flawed surgical strategy. We report 2 cases: a primary lymphoma of the Meckel cave and a metastasis lymphoma in the prepontine cistern arising from the supraclavicular lymph node.Case DescriptionThe first patient presented with a 3-month history of persistent, sharp facial pain across the area innervated by the V2 nerve. She was misdiagnosed with primary trigeminal neuralgia and underwent microvascular decompression. Intraoperatively, the trigeminal nerve was swollen to a large extent and surrounded by red granuloma-like tissue. The second case was a 75-year-old woman; she had a history of a malignant lymphoma of the supraclavicular lymph node and presented with right facial pain. Magnetic resonance imaging revealed that the cisternal portion of the right trigeminal nerve was swollen. A specimen was taken from the 2 patients, and histopathologic examinations revealed a diffuse large B cell lymphoma.ConclusionsThe diagnosis of a malignant lymphoma should be considered for lesions in the trigeminal region. Extracting a specimen for biopsy is the most suitable surgical strategy. Our report indicates that postoperative adjuvant chemotherapy for malignant lymphomas is essential.Copyright © 2018. Published by Elsevier Inc.

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