LAUSR

The trigeminal ganglion is an atypical site for metastasis, especially for renal clear cell carcinoma (RCC). We report two clinical cases of 66- and 58-year-old men with trigeminal symptoms. Both patients had a history of RCC which was considered to be cured at six and nine years, respectively. Brain magnetic resonance imaging (MRI) showed a trigeminal ganglion lesion with increased gadolinium enhancement associated with petrous apex erosion. The main diagnostic hypothesis based on MRI was trigeminal schwannoma for both patients. One patient underwent subtotal removal, the other a biopsy. Histological examinations resulted in the diagnosis of RCC metastasis. Body computed tomography revealed pancreatic metastasis for both but no renal recurrence. The patients were treated by local radiotherapy, and one of the patients had associated chemotherapy. We added to these clinical cases, a literature review of skull base metastasis of RCC. Trigeminal ganglion metastasis of RCC is very rare and can persist until 10 years after the first RCC diagnosis. It seems that the best treatment is surgical removal. So far, the role of local radiotherapy is not demonstrated, and the prognosis seems to be poor. In the case of trigeminal symptoms, rapid tumoural growth on brain MRI, or a history of RCC, we think that a body computed tomography should be performed, and surgery should be considered.