Solitary neurofibroma presenting as a tender soft-to-firm tumor at the temporal head region masquerading as temporal arteritis

DOI Web Site 25 References
  • Inamori Masato
    Department of Neurology, Neurological Institute, Graduate School of Medical Sciences, Kyushu University
  • Doi Hikaru
    Department of Neurology, Neurological Institute, Graduate School of Medical Sciences, Kyushu University
  • Tateishi Takahisa
    Department of Neurology, Neurological Institute, Graduate School of Medical Sciences, Kyushu University
  • Matsuoka Takeshi
    Department of Neurology, Neurological Institute, Graduate School of Medical Sciences, Kyushu University Department of Neurolopathology, Neurological Institute, Graduate School of Medical Sciences, Kyushu University
  • Iwaki Toru
    Department of Neurolopathology, Neurological Institute, Graduate School of Medical Sciences, Kyushu University
  • Kira Jun-ichi
    Department of Neurology, Neurological Institute, Graduate School of Medical Sciences, Kyushu University

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Other Title
  • 側頭部有痛性索状腫瘤を呈し側頭動脈炎との鑑別を要した孤発性神経線維腫の１例
  • 症例報告 側頭部有痛性索状腫瘤を呈し側頭動脈炎との鑑別を要した孤発性神経線維腫の1例
  • ショウレイ ホウコク ソクトウブ ユウツウセイ サクジョウ シュリュウ オ テイシ ソクトウ ドウミャクエン トノ カンベツ オ ヨウシタ コハツセイ シンケイ センイシュ ノ 1レイ

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Abstract

We reported a 59-year-old woman who had complained of right temporalgia for 5 years. She was first diagnosed with a carious tooth, but treatment did not alleviate the pain. She then developed right facial pain and numbness at the right side of the tongue tip. In spite of repetitive examinations and medications, temporalgia worsened in August, 2007. Neurological examination on admission revealed a palpable soft-to-firm tumor with tenderness at the right temporal head region, right facial pain radiating to the right forehead induced by tapping on the middle of the forehead, and dysesthesia at the right tip of the tongue. C-reactive protein was negative and erythrocyte sedimentation rate was normal. Ultrasonographic examination showed beads-like tumors with low-echoic lesions without blood flow. MRI demonstrated multiple small ovoid lesions in the right subcutaneous tissue of the right temporal head. Although we initially suspected temporal arteritis, these findings were contrary. Tumor biopsy finally revealed solitary neurofibroma of the right auriculotemporal nerve. A sporadic localized intraneural neurofibroma at the extracranial region is an uncommon entity. Furthermore, nerve sheath tumors of the trigeminal nerve rarely manifest with intermittent painful burning or crawling sensations simulating trigeminal neuralgia. The present case manifested as a tumor with tenderness at the right auriculotemporal nerve and mimicked temporal arteritis. Therefore, it is important to understand that neurofibroma of the auriculotemporal nerve can mimic temporal arteritis and manifest with trigeminal neuralgia-like pain.<br>

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