• Céline Salaud, Vincent Roualdes, François Thillays, Stéphane André Martin, and Kévin Buffenoir.
• Department of Neurotrauma/Neurosurgery, Nantes University Hospital, Saint-Herblain, France. Electronic address: celine.salaud@chu-nantes.fr.
• World Neurosurg. 2019 Aug 1; 128: 541-546.

BackgroundThe trigeminal ganglion is an atypical site for metastasis, especially for renal clear cell carcinoma.Case DescriptionWe report 2 clinical cases of a 66-year-old man and a 58-year-old man with trigeminal symptoms. Both patients had a history of renal clear cell (RCC) that was considered to be cured at 6 and 9 years, respectively. Brain magnetic resonance imaging (MRI) showed a trigeminal ganglion lesion with increased gadolinium enhancement associated with petrous apex erosion. The main diagnostic hypothesis based on MRI was trigeminal schwannoma for both patients. One patient underwent subtotal removal, the other a biopsy. Histologic examinations resulted in the diagnosis of RCC metastasis. Body computed tomography revealed pancreatic metastasis for both but no renal recurrence. The patients were treated by local radiotherapy, and 1 of the patients had associated chemotherapy. We added to these clinical cases a literature review of skull base metastasis of RCC. Trigeminal ganglion metastasis of RCC is very rare and can persist until 10 years after the first RCC diagnosis. It seems that the best treatment is surgical removal. To date, the role of local radiotherapy is not demonstrated, and the prognosis seems to be poor.ConclusionsIn the case of trigeminal symptoms, rapid tumoral growth on brain MRI, or a history of RCC, we think that a body computed tomography should be performed, and surgery should be considered.Copyright © 2019. Published by Elsevier Inc.

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