The location of the tumor can be anywhere along the course of the trigeminal nerve.
(1) brain
(2) brainstem
(3) preganglionic region
(4) Gasser's ganglion
(5) cavernosal sinus
(6) along the peripheral course of a branch
Tumors involved may include:
(1) neurinoma on or compressing the trigeminal nerve
(2) primary benign or malignant tumors in the nasopharynx, maxillary sinus or mandible
(3) primary benign or malignant brain tumor
(4) metastatic carcinoma (breast, prostate, lung, head and neck, malignant lymphoma, other)
Clinical features:
(1) partial or complete facial numbness along the distribution of the trigeminal nerve
(2) facial pain
(3) variable presence of hyperesthesia
(4) other effects associated with the tumor (bone pain, weight loss, etc)
In some cases the onset of trigeminal neuralgia may be the first sign of the underlying tumor.
A patient with a history of malignancy who develops trigeminal neuralgia should be evaluated for a metastasis. The prognosis for these patients are often poor.
