Recurrent Trigeminal Schwannoma with Parapharyngeal Extension: A Rare Cause of Facial Pain

Abstract

Trigeminal Schwannoma is a rare benign tumor of less than 1 % of all intracranial tumors. Trigeminal nerve involvement is the second most common in the head and neck region. They are slow growing and usually arise from sensory divisions of the trigeminal nerve. Orofacial pain and swelling is key clinical features with motor loss in advanced disease. Magnetic resonance imaging (MRI) is diagnostic. Surgery with wide margins is the mainstay of treatment along with adjuvant radiotherapy. We report a case of recurrent Trigeminal Schwannoma in a young female presented as recurrent orofacial pain and swelling. She had undergone surgery few months ago without adjuvant radiotherapy. MRI shows abnormal signal area which is very locally advanced reaching to oral cavity, para pharyngeal space and infratemporal fossa. She was denied for resurgery and definitive radiotherapy was suggested but patient did not pursue due to unknown reasons.