Ancient Schwannoma of the Trigeminal Nerve Mimicking High Grade Lesion

Ancient schwannomas rarely found in the central nervous system and ancient change in an intracranial schwannoma (intracranial portion of the trigeminal nerve) is extremely rare. A seventy-year man presented with headache of 3 months duration and one episode of generalized tonic-clonic seizures. Imaging findings were suggestive of left temporal high grade lesion. During surgery there was well capsulated extra-axial lesion. Histology was suggestive of ancient schwannoma. Based on the literature it is suggested when the intraoperative appearance of a cerebello-pontine lesion is consistent with a schwannoma and the frozen section is suggestive of a malignant lesion, a complete excision of the lesion can be carried out.