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DISTANT METASTASIS - The Trigeminal Nerve

Now viewing: Case 2

Case 2 - Recurrent squamous cell carcinoma of left cheek with metastasis to left maxillary division of trigeminal nerve
Operative findings: there was perineural metastasis to the maxillary division of the trigeminal nerve. The foramen rotundum was enlarged with a large maxillary division of the trigeminal nerve. The foramen ovale did not appear grossly abnormal, however, the mandibular division of the trigeminal nerve was somewhat thickened and enlarged. The gasserian ganglion was tight down upon the foramen ovale. A segment of the second division of the trigeminal nerve was removed for frozen section. Histopathology revealed infiltrative squamous cell carcinoma, neural invasion.
Axial T1-weighted MR image (TR 600/TE 25) at the level of the maxillary sphenoid sinuses : enlargement of the left infraorbital nerve with expansion of the canal is well shown (1). There is an extension of the lesion to the left inferior orbital fissure and left pterygopalatine fossa. (2). Coronal T1-weighted MR image (TR 600/TE 20) at the level of the anterior sphenoid sinuses: slight enlargement of the left foramen rotundum with heterogeneous soft tissue densities is well shown (arrow). The right foramen rotundum is normal (1).

 

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