Trigeminal Schwannoma Presenting as Facial Neuralgia: A Case Report

Trigeminal schwannomas are rare, benign nerve sheath tumors, accounting for less than 1% of all intracranial schwannomas. Clinically, they frequently present with facial neuralgia or sensory disturbances, and magnetic resonance imaging (MRI) remains the cornerstone for diagnosis. We report the case of a 65-year-old male with a four-month history of right-sided facial pain localized to the V2 and V3 trigeminal distributions. MRI revealed a right cerebellopontine angle mass centered on the cisternal segment of the trigeminal nerve, with extension into Meckel’s cave. Management strategies for trigeminal schwannomas range from conservative observation to stereotactic radiosurgery. However, microsurgical resection remains the gold standard, offering immediate local tumor control and histopathological confirmation, albeit with a potential risk of neurologic deficits. Following complete resection, functional outcomes are generally favorable. Despite their benign nature and minimal risk of malignant transformation, long-term MRI surveillance is warranted to detect recurrence.