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Glossopharyngeal nerve schwannoma

Case contributed by Shirish Paul
Diagnosis almost certain

Presentation

Jabbing pain right half of tongue, ear and posterior aspect of throat associated with difficulty chewing

Patient Data

Age: 30 years
Gender: Female

MR images

mri

Glossopharyngeal nerve schwannoma in the right cerebellopontine angle extending through the pars nervosa to the right half of skull base. There is associated atrophy of the posterior right tongue.

Case Discussion

This lesion arises from the right glossopharyngeal nerve in the anterior jugular foramen (pars nervosa). The patient underwent retromastoid suboccipital craniotomy and excision of the mass, confirming the diagnosis.

Cranial nerve schwannomas account for about 8-10 % of brain tumors. The most common nerve involved is the vestibular division of the vestibulocochlear nerve (CN VIII). This is followed by trigeminal (V), facial (VII) and hypoglossal (XII) nerves.

Schwannomas arising from the 9th,10th, and 11th cranial nerves are called jugular foramen schwannomas. There are only 37 recorded cases of glossopharyngeal nerve schwannomas. Incidence without neurofibromatosis is very rare.

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