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Rhabdomyomatous Mesenchymal Hamartoma of the Face Causing Trigeminal Neuralgia

Unusual clinical course, Challenging differential diagnosis

Leon R. White, Jr, Vaidehi Agrawal, Lisa Sutton, Aiysha C. Balbosa

(Texas College of Osteopathic Medicine, University of North Texas Health Science Center, Fort Worth, TX, USA)

Am J Case Rep 2015; 16:338-340

DOI: 10.12659/AJCR.893719

Published: 2015-06-03

BACKGROUND: Rhabdomyomatous mesenchymal hamartoma (RMH) is a benign, potentially pigmented lesion that occurs in the head and neck region. It generally consists of haphazardly arranged skeletal muscle with adipose tissue, blood vessels, collagen and nerve fibers and is largely asymptomatic. Trigeminal neuralgia is pain due to compression of the trigeminal nerve. TN may be idiopathic or associated with lesion-mediated compression.
CASE REPORT: We describe the case of a 14-year-old female presenting with trigeminal neuralgia (TN) associated with RMH. On initial consultation, the patient presented with a history of right-sided lower facial swelling, numbness, and pain. Evaluation by various specialists confirmed TN. Surgical resection of the lesion resolved the condition and pathology confirmed RMH.
CONCLUSIONS: This is the first case report demonstrating RMH-mediated TN. Surgical resection of the RMH is a safe management approach for this diagnosis.

Keywords: Diagnosis, Differential, Adolescent, Face, Female, Hamartoma - surgery, Humans, Skin Diseases - surgery, Trigeminal Neuralgia - surgery