Orofacial pain secondary to acoustic neuroma-A case report

Aim: The present study aimed to report a case of orofacial pain secondary to acoustic neuroma (AN).

Methods and results: A 66-year-old female presented with unilateral facial pain and odontalgia. The pain was described as throbbing, dull, and constant. Tinnitus, hearing loss, dizziness, and others symptoms were also present. Due to the characteristics of the pain and clinical or radiographic findings, other possible diagnoses, such as temporomadibular disorder, tooth-related pain, sinusitis, and primary headaches, were excluded. Somatosensory tests for allodynia and hyperalgesia showed extraoral and intraoral hypersensitivity. Magnetic resonance imaging revealed a lesion located on the right cerebellopontine angle extending into and obliterating the internal auditory canal and compressing the middle cerebral peduncle, the pons, and the cisternal segment of cranial nerve V. The patient was diagnosed with a brainstem tumor compatible with AN and trigeminal neuralgia secondary to cranial nerve V compression.

Conclusion: Although uncommon, intracranial tumors should be considered during orofacial pain evaluation to avoid iatrogenic treatment and delayed diagnosis.