A rare case study of a retropharyngeal neurofibroma and a brief literature review

Sporadic diffuse neurofibroma of the retropharyngeal space

Neurofibroma (NF) rarely arises in the retropharyngeal space (RPS) of patients with or without Neurofibromatosis type I (NF-I). The diffuse subtype of NF (DNF) is characterized by an infiltrative growth pattern and typically involves the skin and subcutaneous tissue of the head and neck. We describe the clinic-pathologic features of a DNF involving the RPS of an adult without NF-I. To date, this subtype of NF has never been reported at this site.

Isolated neurofibromas of the great auricular nerve: A rare localization in a pediatric patient with neurofibromatosis type-1

Peripheral nerve sheath tumors encompass a spectrum of well-defined clinicopathologic entities, ranging from benign tumors, such as neurofibromas, to high grade malignant neoplasms termed malignant peripheral nerve sheath tumors. Morphologic variability of these tumors is wide, and they engender some of the most controversial, difficult differential diagnoses. Localized neurofibromas often involve a major nerve and result typically in fusiform expansion of the nerve trunk (intraneural subtype). We report a case of circumscribed solitary neurofibromas in a 14-year-old boy with NF1 who presented to our department with a left neck swelling. The neurofibromas lesion involved the anterior branch of the great auricular nerve. The sensory symptoms initially reported by the patient (paresthesia and hyperesthesia) in the lower preauricular region. Surgical treatment represents the therapeutic method of choice in the approach to neurofibromas, considering functional disorders and possible aesthetic deformities. The case described presented difficulties in surgical excision, based on risk of functional and aesthetic results.

A rare cause of cervical swelling: Solitary plexiform neurofibroma

INTRODUCTION

Plexiform cervical neurofibromas are benign neoplasm, extremely rare, difficult to diagnose and to manage. Only some cases have been reported in the literature.

CASE PRESENTATION

We report the case of a 60-year-old man admitted for a lateral neck mass, for which the surgical indication was the increase in volume of this mass, as well as the aesthetical impairment, the surgical exploration found the tumor attached to the cervical plexus. The excision of the mass was performed without damaging nerve. The pathological study was in favor of a plexiform neurofibroma.

DISCUSSION

Even though Plexiform cervical neurofibroma are extremely rare, and their diagnosis are not often primary evoked in front of any growing mass of this region, the surgeon must keep in mind the existence of these neoplasms as a differential diagnosis of a neck tumor.

CONCLUSION

Surgery remains the gold standard in the treatment of these locally invasive tumors. It is essential that the surgeon keep in mind the possibility of these tumors as a differential diagnosis of a neck tumor.

Solitary extraosseous neurofibroma in a 5-year-old child - A case report

Rationale:

Neurofibroma (NF) is the most common benign peripheral nerve sheath tumour that most often occurs as a solitary tumour. A clinical and imaging diagnosis may be challenging since no distinctive features are unique for this lesion. Solitary NFs are treated by complete resection that may sometimes require a nerve sacrifice, ending with a neurological deficit.

Patient Concerns:

A 5-year-old girl with mild asymptomatic slow-growing swelling in the vestibulum of her right mandible.

Diagnosis:

A solitary variant of extraosseous NF involving the right mental branch of the inferior alveolar nerve.

Treatment:

Surgical removal of the lesion while fully preserving the mental branch.

Outcomes:

No sensory deficit was identified during a 3-month follow-up.

Take-Away Lessons:

Ultrasonography is a valuable tool for evaluating soft-tissue masses of the oral cavity. A solitary extraosseous NF involving the mental branch can be surgically removed without nerve deficit.

Peripheral neck nerve tumor: A 73-case study and literature review

OBJECTIVES

Peripheral neck nerve tumors are rare and mostly benign neoplasms. The exceptional malignant forms are very aggressive, and diagnosis is difficult. The objective of this study was to evaluate diagnostic and therapeutic management and identify possible predictive factors.

MATERIAL AND METHODS

A retrospective study was conducted of 73 patients treated for peripheral neck nerve tumor between 1995 and 2015.

RESULTS

Mean age was 44years. The main presenting symptom was a cervical mass, isolated or associated with signs related to the affected nerve structure. Diagnosis was suspected by slow progression of a firm mass, featuring T1 hyposignal and T2 hypersignal on magnetic resonance imaging. Surgery was performed in 99% of cases, completed by adjuvant chemotherapy in case of malignant neuroblastic tumor. Type 1 neurofibromatosis and sudden increase in mass with or without associated pain suggested malignant transformation. Age below 10years suggested neuroblastic tumor.

CONCLUSION

Neck nerve tumors are very often benign with low degenerative potential. Surgery is the treatment of choice after risk/benefit analysis. However, there is no clearly defined consensus regarding the timing of surgery for these lesions.

Ganglioneuroma of the retropharyngeal space in a patient with glottic cancer

We describe the case of a 71-year-old man with a ganglioneuroma of the retropharyngeal space. The patient presented with a submucosal bulge of the left oropharyngeal wall during follow-up examination of a treated vocal cord carcinoma. CT and MRI revealed a non-specific, well-defined retropharyngeal soft tissue lesion. Positron emission tomography-CT did not show relevant metabolic activity, excluding the hypothesis of metastatic nodal disease. Surgical biopsy of the lesion was compatible with ganglioneuroma. Ganglioneuromas are well-differentiated tumours composed of mature sympathetic ganglion cells that account for approximately 1% of spinal and paraspinal tumours. Peripherally, ganglioneuromas are predominantly found in the posterior mediastinum and retroperitoneal space. Only nine ganglioneuromas of the retropharyngeal space have been reported in the English literature since the early 1980s.

A huge retropharyngeal bronchogenic cyst displacing the posterior wall of the hypopharynx: Case report and review of the literature

Lesions of the retropharyngeal space (RPS) are uncommon, and they generally present as solitary, painless masses, which are often cystic. They usually originate from branchial arches anomalies, and only in a few cases do they turn out to be bronchogenic cysts. Generally, these lesions are diagnosed in childhood, but sometimes they can appear in adulthood. We report here a rare case of a bronchogenic cyst expanding into the RPS and causing dysphagia in an adult patient treated surgically. Since the RPS is clinically inaccessible, clinical examination was not crucial in determining the correct diagnosis, and only the additional information provided by radiological examinations led to the final diagnosis, which is essential for accurate surgical planning.