三叉神経痛症状を呈した高齢者に発見された小脳橋角部の類上皮腫の２例

Cerebellopontine angle

北海道歯学会

北海道歯学雑誌

An elderly woman presented to our department complaining of tongue or maxillary pain. Trigeminal neuralgia was suspected and carbamazepine was administered. The pain was generally controlled. Herein, we report two cases in which epidermoid tumors of the cerebellopontine angle were detected using magnetic resonance imaging following consultation with neurosurgery to investigate the central cause. 　Case 1. An 81-year-old woman developed intense intermittent pain in the left mandibular body after dental treatment, followed by tingling pain in the left tongue margin. Her previous physician suspected a combination of glossodynia and trigeminal neuralgia, but her symptoms improved spontaneously. However, subsequently, the tongue pain became extremely severe and was accompanied by a burning sensation in the entire mouth. Therefore, the patient was referred to our department. 　Case 2. A 79-year-old woman was treated for oral candidiasis. She noticed shooting pain in the left maxillary tuberosity and was hence referred to our department. 　Upon close examination at our department, trigeminal neuralgia was suspected in both cases. Hence, carbamazepine was prescribed, which showed a temporary effect. Although the condition showed a tendency of relapsing shortly, the pain could be controlled by increasing carbamazepine dose. Hence, we consulted neurosurgery to investigate the central cause. 　In both cases, magnetic resonance images showed epithelioid tumors in the cerebellopontine angle. Both patients were elderly and were treated with pharmacotherapy considering their current symptoms and risk of surgery