Primary facial nerve paraganglioma: report and review of the literature

BMJ Case Rep. 2020 Dec 9;13(12):e237537. doi: 10.1136/bcr-2020-237537.

Abstract

This report describes the diagnosis and treatment of a patient with a rare primary facial nerve paraganglioma as well as a review of the current literature. A 60-year-old male patient presented to our clinic with a 4-month history of left-sided progressive facial paralysis House-Brackmann V. Biopsy taken during facial nerve (FN) decompression confirmed the diagnosis of paraganglioma. The left FN was sacrificed during resection of the mass and a 12-7 jump graft, using the left greater auricular nerve, was performed with acceptable outcomes. The rarity of these tumours does not discount their clinical importance or the necessity to include them in the differential when presented with unilateral FN paralysis. Investigation should begin with CT and MRI imaging to identify and localise the potential mass. Histologic confirmation requires tissue. While surveillance imaging is occasionally an option, often complete surgical resection of the mass and sacrifice of the nerve is necessary.

Keywords: cranial nerves; endocrinology; interventional radiology; otolaryngology / ENT; plastic and reconstructive surgery.

Publication types

  • Case Reports
  • Review

MeSH terms

  • Cranial Nerve Neoplasms / diagnosis*
  • Cranial Nerve Neoplasms / pathology
  • Cranial Nerve Neoplasms / surgery
  • Facial Nerve Diseases / diagnosis*
  • Facial Nerve Diseases / pathology
  • Facial Nerve Diseases / surgery
  • Facial Paralysis / etiology
  • Hearing Loss, Sensorineural / etiology
  • Humans
  • Magnetic Resonance Imaging
  • Male
  • Middle Aged
  • Paraganglioma / diagnosis*
  • Paraganglioma / pathology
  • Paraganglioma / surgery
  • Tomography, X-Ray Computed