2019 年 26 巻 1 号 p. 40-43
Background: Cerebellopontine angle epidermoid is a rare congenital tumor. This is a slow growing benign tumor with late presentation in adulthood. There is a possibility of missed diagnosis. Case Presentation: A 56 year-old woman had intermittent left cheek pain for 10 years. The patient was diagnosed with typical trigeminal neuralgia (TGN) at a general hospital. She was treated with a satellite ganglion block and oral medication. As a typical trigeminal neuralgia, the nature of pain was atypical. During the first examination, sensory disturbances in the second branch of the trigeminal nerve in the left side and delayed light reflexes of the left pupil were detected. Cranial magnetic resonance imaging (MRI) was performed. The result of the MRI showed a cerebellopontine angle epidermoid tumor. TGN resolved completely after near complete tumor resection. Upon removal of the tumor, the patient required no analgesics. Conclusion: We reported a case of TGN due to epidermoid. The diagnosis was made after a thorough neurological examination. Regular MRI is also necessary. This is because symptoms are exhibited even if the tumor is small. To ensure correct diagnosis and treatment, careful case management in the pain clinic is necessary.
