Lipoma causing glossopharyngeal neuralgia: a case report and review of literature.

Abstract

The cerebello-pontine angle lipomas causing trigeminal neuralgia or hemifacial

spasm are rare. A lipoma causing glossopharyngel neuralgia is also very rare. A

46-year-old woman complained of 2-year history of severe right throat pain, with

ipsilateral episodic otalgic pain. The throat pain was described as an episodic

lancinating character confined to the throat. Computed tomography and magnetic

resonance imaging revealed a suspicious offending posterior inferior cerebellar

artery (PICA) compressing lower cranial nerves including glossopharyngeal nerve.

At surgery, a soft, yellowish mass (2x3x3 mm in size) was found incorporating the

lateral aspect of proximal portion of 9th and 10th cranial nerves. Only

microvascular decompression of the offending PICA was performed. Additional

procedure was not performed. Her severe lancinating pain remained unchanged,

immediate postoperatively. The neuralgic pain disappeared over a period of

several weeks. In this particular patient with a fatty neurovascular lump causing

glossopharyngeal neuralgia, microvascular decompression of offending vessel alone

was enough to control the neuralgic pain.