Solitary intrabony neurofibroma of the maxilla

Solitary intraosseous neurofibroma of the oral cavity: rare localization in the maxilla

BACKGROUND

Neurofibroma is a common benign tumor of neuronal origin that can occur as a solitary tumor or as a component of the generalized syndrome of neurofibromatosis. Neurofibromas are primarily located in the subcutaneous soft tissues and commonly involve extra-oral sites. Solitary intraosseous neurofibromas of the oral cavity are infrequent, with occurrences in the maxilla being exceedingly rare.

CASE PRESENTATION

A 22-year-old male patient presented with an asymptomatic mass in the maxilla. Cone-beam computed tomography revealed a round, well-outlined, radiolucent lesion with expansive growth. The neoplasm with the complete capsule was completely removed and confirmed as a neurofibroma based on histopathological and immunohistochemical findings. The reported cases of solitary intraosseous neurofibromas located in the maxilla published in the English literature were compiled to assist in the diagnosis of solitary intraosseous neurofibromas of the maxilla. Nine months after the surgery, there were no signs of tumor recurrence or malignant transformation.

CONCLUSIONS

This report emphasizes that rare locations of neurofibromas, such as solitary intraosseous neurofibromas in the maxilla, typically demonstrate nonspecific clinical and radiological features. Clinicians should consider solitary intraosseous neurofibromas as possible differential diagnoses and recognize the histopathological and immunohistochemical features to confirm the correct diagnosis. A longer follow-up period is required because of the potential for local recurrence and malignant transformation of these tumors.

Intraosseous Neurofibroma of Mandible in a 5-Year-Old: A Rare Case Report and Review of Literature

Neurofibromas are benign tumours originating from the peripheral nerve sheath mainly the endoneurium. The lesion can occur in a solitary form or as multiple tumours associated with neurofibromatosis (NF-1), which is also known as von Recklinghausen's disease. Intraosseous neurofibromas are exceedingly rare with only less than 50 cases reported in the literature. We report a case of paediatric neurofibroma of the mandible which is even more rare with only 9 cases reported so far. Hence, systematic and thorough investigations are mandatory to correctly diagnose and plan appropriate treatment for intraosseous neurofibroma because of the rarity of the lesion in the paediatric age group. The clinical presentations, diagnostic challenges and treatment plan with a thorough review of literature have been addressed in this case report. The purpose of this paper is to present a case of pediatric intraosseous neurofibroma and to  stress the importance of considering such a rare lesion in the differential diagnosis of jaw lesions, especially in children to reduce functional and aesthetic morbidity.

Intraosseous Neurofibroma of the Mandible: A Case Report and Review of Literature

Neurofibroma (NF) is a benign tumor of the peripheral nervous system. Head and neck NF are generally located in the soft tissue. The tumour is rarely seen intraosseously and most commonly such tumours are seen as solitary lesions, rather than part of neurofibromatosis. The following report describes a case of an intraosseous neurofibroma in a 45-year-old male located in the left posterior mandible. The diagnosis was made based on the clinical findings, radio graphical features, histopathology, and immunohistochemistry. A literature review has been done on intraosseuos neurofibromas located in the jaws, with a discussion on the possible differential diagnosis.

Unusual Case of a Proptosed Eye: Isolated Right Maxillary Neurofibroma

Neurofibroma is a slow growing benign tumour of the peripheral nerve sheath which is frequently associated with neurofibromatosis type 1 (Prakash et al., 2014). Isolated solitary occurrence of neurofibroma in the maxillary sinus is rare with only 29 reported cases in the literature. We present a rare case of a 70-year-old gentleman who was referred to ENT with a right maxillary sinus neurofibroma with extension into the right inferior orbit. He has significant proptosis, ptosis, and limitation in abduction of the right eye. He has a complicated past history of multiple neurofibromas which were completely excised. Craniofacial MRI shows a large mass filling the right maxillary antrum extending anteriorly into subcutaneous tissue towards nasal ala and posterolaterally into inferior temporal fossa and superiorly into orbit and cavernous sinus involvement. Biopsy of the right maxillary mass revealed cellular spindle cell tumour with wavy collagen bundles within myxoid stroma which is consistent with a neurofibroma. Patient's case was discussed in the skull-base MDT and he has been referred to a specialist center for surgical removal of the neurofibroma with reconstructive surgery. Despite the rarity of this disease, otorhinolaryngologist should consider a possibility of neurofibroma of the paranasal sinuses.

Neurofibroma of sinus maxillae

Neurofibroma is a benign tumour composed from Schwann cells. Localization in sinus maxillea is very rare. Authors presenting case which was treatment in Maxillo-Facial Surgery Clinic in Wrocław.

[Solitary neurofibroma of the maxillary sinus]

OBJECTIVE

To illustrate the rarity and difficulty diagnosing maxillary sinus neurofibroma through a case report.

PATIENTS AND METHODS

A 35-year-old female consulted our department for left cheek swelling evolving over 6 months, upper gum swelling, and a dental occlusion disorder.

RESULTS

A computed tomography scan showed a tumor of the left maxillary sinus with bone destruction. Histological examination of a biopsy fragment found an in situ carcinoma. A maxillary resection was performed to excise the tumor. Histological examination of the specimen showed a neurofibroma. No sign of recurrence was noted after 8 months of follow-up.

CONCLUSION

The difficulty diagnosing maxillary sinus neurofibroma is related to its nonspecific clinical and radiological signs. Consequently, the otorhinolaryngologist must keep this rare histological variety in mind within the range of tumors of the paranasal sinuses.

Role of Maxillofacial Surgery in Patients With Neurofibromatosis Type I

Neurofibromas are a clinical manifestation of neurofibromatos is type I (NF1). Management of these tumors remains a challenge for the clinician. The goal of the present study is to point out treatment guidelines for these lesions. Eighteen patients diagnosed with NF1 and presenting lesions of the craniomaxillofacial district were included in the study. On the basis of clinical evidence and patient's expectations, only six patients of this group underwent surgery. All patients that had no surgery were included in a follow-up protocol to evaluate progression of disease. Four patients who underwent surgery had good functional/aesthetic results, whereas two patients had incomplete rehabilitation.