Syphilitic Gumma Lesion in Meckel's Cave and Infratemporal Fossa Presenting with Cranial Nerve Deficit

Abstract

We describe the case of a 54-year-old man presenting with symptoms of left otalgia with irradiation to the jaw. Initial investigation revealed an isointense T1, hypointense T2, and homogenously enhancing nodular lesion invading the left Meckel’s cave, spreading into rotundum and ovale foramina toward the infratemporal fossa. There was also infiltration of the pterygoid muscles. Biopsy was done through an endoscopic transmaxillary approach directed at this lesion in the pterygomaxillary and infratemporal fossa. The initial diagnosis was hemangioma.