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Figure 1: T1 Axial Fat Saturated, Gadolinium enhanced MRI scan of the head. This image displays the case of a 48-year-old man with a previous excision of a neurotropic melanoma of the face. Approximately one year from wide local excision he presented with facial pain and biopsy proven recurrence of neurotropic melanoma involving the mandibular division of the trigeminal nerve, filling the cavernous sinus and prepontine cistern with obvious brainstem compression.