Solitary oral plexiform neurofibroma: review of literature and report of a case

Excision of Solitary Non-syndromic Oral Plexiform Neurofibroma Utilizing a Diode Laser: A Case Report

Plexiform neurofibroma is a benign peripheral nerve sheath tumor known to be pathognomonic for neurofibromatosis type 1. However, solitary plexiform neurofibroma in the oral cavity is extremely rare. Herein, we presented a 73-year-old Saudi male with solitary plexiform neurofibroma located on the maxillary alveolar ridge, which was excised successfully using a 940 nm diode laser. Microscopic examination revealed a multinodular arrangement of benign spindle cells in a haphazard pattern. Immunohistochemical analysis showed positive staining for S100 and CD34 in the tumor cells.

Solitary plexiform neurofibroma of the tongue: report of a case with no evidence of neurofibromatosis type 1

Neurofibromas are frequently present in the skin, but are uncommon in the oral and maxillofacial region. There are three histological variants of neurofibroma: localized, diffuse, and plexiform. The plexiform histological variant of neurofibroma is the least common and is a rare occurrence in the oral cavity. Furthermore, plexiform neurofibroma is usually pathognomonic of neurofibromatosis type 1. A case of solitary plexiform neurofibroma of the tongue with no evidence of neurofibromatosis in a 50-year-old female Chinese patient is reported here. The lesion presented as a single, large, well-circumscribed rounded mass in the left hemi-tongue. The tumour was completely excised. No recurrence was observed at the 6-month follow-up.

Safety and Efficacy of Endoscopic Treatment of Solitary Gastric Neurofibroma

Purpose

The studies on solitary gastric neurofibroma (GN) consist of only individual case reports, with little data and relevant information. We aimed to summarize the clinical features, endoscopic features, imaging findings, and pathological features and study the safety and efficacy of endoscopic treatment of solitary GN.

Patients and Methods

We retrospectively collected and analyzed clinical data of patients who underwent endoscopic treatment in Department of Gastroenterology of a well-known tertiary hospital from August 2007 to September 2019 and were accurately diagnosed as having solitary GN.

Results

A total of 788 patients with gastric submucosal tumors underwent endoscopic treatment, among whom 11 patients were found to have solitary GNs. The incidence of solitary GNs was 1.4%. All 11 patients were treated with endoscopy. Five patients underwent endoscopic full-thickness resection (EFTR) and six patients underwent endoscopic submucosal excavation (ESE). The en bloc resection rate of the 11 lesions was 100.0%. The median endoscopic operation time was 80 minutes. Average length of hospital stay was 6.4 ± 1.6 days. The median follow-up time was 29 months. No recurrence, distant metastasis, or disease-related death occurred during the follow-up.

Conclusion

EFTR and ESE can serve as feasible, safe, and effective treatments for solitary GN.

A rare case of plexiform neurofibroma of the liver in a patient without neurofibromatosis type 1

Plexiform neurofibroma is mainly associated with neurofibromatosis type 1 and is seldom observed in the liver. Its occurrence in the liver without neurofibromatosis type 1 is even rarer. We report an extremely rare case of plexiform neurofibroma of the liver diagnosed by laparoscopic biopsy in a patient without neurofibromatosis type 1. The patient was a 35-year-old man who had neither clinical signs nor any family history of neurofibromatosis type 1. Abdominal ultrasonography, as part of a health screening, had detected a hepatic tumor. Subsequent contrast ultrasonography, computed tomography, and magnetic resonance imaging showed the tumor extending from the retroperitoneal space around the aorta to the hepatic hilum and distal portal branches in the right hepatic lobe, gallbladder, and left hepatic lobe. ¹⁸F-fluorodeoxyglucose positron emission tomography showed no abnormal accumulation. Histopathological examination of the tumor obtained laparoscopically led to a diagnosis of plexiform neurofibroma. Because the patient was asymptomatic with no features of malignancy, he was only monitored and managed. At follow-up 10 years later, computed tomography showed a decrease in tumor size. It is important to recognize that, while rare, plexiform neurofibroma can occur without neurofibromatosis type 1. We recommend follow-up instead of unreasonable surgery in such cases.

Solitary neurofibroma of the floor of the mouth: rare localization at lingual nerve with intraoral excision

Background

Neurofibromas (NF) are benign tumors of the peripheral nerves that are composed of Schwann cells, perineural-like cells and fibroblasts. The differential diagnosis for a solitary intraneural variant of neurofibroma arising in the floor of the mouth is broad and includes a submandibular gland neoplasm and adenopathy, among others. The intraoral approach is the best choice for a medium-sized lesion.

Case presentation

We report a rare case of a solitary neurofibroma of the floor of the mouth in a 31-year-old male. The patient consulted the dental emergency department for acute pain of the left mandible. Systematic clinical examination revealed the presence of a mass in the left mouth floor. The panoramic x-ray was not conclusive and the magnetic resonance imaging (MRI) revealed a well-defined soft tissue lesion with homogenous isosignal intensity on the T1-weighted image, high intensity signal on the T2-weighted image and heterogeneous enhancement following contrast-enhancement on the T1-weighted Fast Sat image. The surgical excision of the soft-tissue neoplasm was accomplished by an intraoral approach. The specimen was sent for histopathologic analysis and Immunohistochemical studies which confirmed the diagnosis of a myxoid predominant intraneural solitary neurofibroma.

Conclusion

The diagnosis of neurofibroma was confirmed by histopathological evaluation and immunohistochemical studies which also excluded other entities in the histopathologic differential diagnosis including schwannoma and a malignant peripheral nerve sheath tumor among other. Localized (solitary) neurofibromas most often occur as sporadic lesions, however; diagnosis of a solitary neurofibroma prompts clinical evaluation to exclude the remote possibility of neurofibromatosis. The purpose of this case report is to raise awareness of the uncommon presentation of neurofibroma and to document the successful management of such a lesion using an intraoral approach.

Endoscopic low-temperature plasma radiofrequency ablation for laryngeal plexiform neurobromatosis-1 in an infant: Case report and review of the literature

To evaluate the feasibility and effectiveness of using endoscopic low-temperature plasma radiofrequency ablation (RFA) for treatment of laryngeal plexiform neurofibromatosis-1 (NF-1). An infant diagnosed as laryngeal plexiform NF-1 based on a detailed medical history, as well as physical, laboratory, and pathological examinations, was treated under general anesthesia with low-temperature plasma RFA in combination with a self-retaining laryngoscope and high definition camera system.The laryngeal plexiform NF-1 tumor was successfully excised using endoscopic low-temperature plasma RFA without complications. Following surgery, the infant displayed an uneventful recovery and no disease recurrence during a 2-year follow-up period. low-temperature plasma RFA is a feasible and effective method for treating laryngeal plexiform NF-1, and has advantages of producing minimal bleeding, providing complete removal of the tumor, and causing only slight degrees of trauma and postoperative tissue reaction.

Solitary plexiform neurofibroma of the stomach: A case report

Plexiform neurofibroma (PN) of the digestive tract is very rare and usually part of the generalized syndrome of neurofibromatosis type 1 (von Recklinghausen disease). Solitary PN of the stomach is extremely rare and has not been reported in the literatures. Here we present a case of solitary PN of the stomach, which was not associated with von Recklinghausen disease. A 38-year-old male presented abdominal pain and distention for 7 d. The patient underwent endoscopy of the upper gastrointestinal tract, which revealed a 3.5 cm protruding and cauliflower-shaped mass with a shallow 1 cm central ulcer in the greater curvature of the stomach. The lesion was removed by laparoscopic surgery. Histological examination demonstrated characteristic histological findings of spindle-shaped cells. Immunohistochemical analysis showed that the tumor cells were positive for S-100 protein, but negative for CD34, KI-67, CD117, and actin. Based on histological findings, gastrointestinal stromal tumor could be excluded, and thus the case was confirmed as PN. We described the clinical features, physical examination, endoscopic findings, and histopathological examination of this case.

Isolated plexiform neurofibroma of the tongue

Neurofibromas (NF) are benign tumors of neural origin, of which roughly 90% appear as solitary lesions. They are classified into cutaneous, subcutaneous, and plexiform subtypes. Plexiform neurofibromas are the least common variant and usually are pathognomonic for NF I. Here, we present a very rare case of isolated plexiform neurofibroma with a painless enlarging mass of the tongue of an 11-year-old girl. This rare benign tumor has the potential for malignant transformation, and the diagnosis was difficult owing to the patient's age and to the insidious clinical presentation. The present case is a diffuse isolated plexiform neurofibroma of the tongue that was not associated with neurofibromatosis that was treated with intraoral surgery.

Solitary plexiform neurofibroma of the gingiva: unique presentation in the oral cavity

Neurofibromas are benign tumours originating from the nerve sheath. Amongst the histological variants, plexiform types are considered exclusive. These are poorly circumscribed, locally invasive and may exhibit sarcomatous potential. Plexiform neurofibromas are key features of Neurofibromatosis - 1 and their solitary intra-oral presentation is uncommon. The following case report describes a unique case of an isolated solitary plexiform neurofibroma of the maxillary anterior gingival region in a middle aged female patient.