gms | German Medical Science

Objective: Neurinomas of the hypoglossal nerve are very rare, and if occurring at all, they are often located intracranially or jointly intra-and extracranially in a dumb-shell shape. The localization of the present neurinoma of the hypoglossal nerve adjacent to the skull base, i.e. solely extracranial, is extremely rare.

Methods: A 23-year-old female patient reported about relapsing headaches. She had been suffering from right-sided hypoglossal nerve palsy for about five to six years. Magnetic resonance imaging (MRI) revealed an extracranial tumor with contact to the skull base adjacent to the hypoglossal nerve. This tumor was extirpated using a posterior far-lateral infracondylar approach while intraoperative monitoring was conducted.

Results: The tumor was completely resected and histologically verified as a neurinoma of the hypoglossal nerve. The patient suffered from hoarseness and a moderate palsy of the right recurrent laryngeal nerve for a period of six weeks.

Conclusions: Pathologies of the hypoglossal nerve are very rare. Whenever tumors are diagnosed, two major questions arise regarding the dignity and the location of the tumor with regard to surgical removal. Although the diagnosis in itself is very unusual, the merely extracranial location of a hypoglossal neurinoma contributes even more to its rareness at the skull base and should thus be noted as a differential diagnosis.