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Rijken BFM, van Veelen-Vincent MLC, Mathijssen IMJ. Sphenoid dysplasia in patients with neurofibromatosis type 1: Clinical features and imaging findings including cerebrospinal fluid alterations. Eur J Paediatr Neurol 2023; 42:28-33. [PMID: 36512957 DOI: 10.1016/j.ejpn.2022.11.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/03/2022] [Revised: 11/14/2022] [Accepted: 11/21/2022] [Indexed: 12/12/2022]
Abstract
INTRODUCTION Neurofibromatosis Type 1 (NF-1) is a genetic disorder that occurs in 1:2500-3000 live births and may involve multiple organs. An uncommon but well-known phenomena is sphenoid dysplasia, which appears in 3-11% of the patients, and may result in significant lowering of the orbit. Understanding the cause and development of this process might predict its course and its treatment. METHODS The records of 29 patients with PNF in the head and neck region were searched for location of the PNF and type of surgery. Photographs were studied for facial disturbances, including vertical dystopia, hypertelorism, ptosis, exophthalmos and enophthalmos. MR and CT scans were studied for the presence of PNF, aspect of the sphenoid bone, alteration in the CSF circulation, and other tumour involvement. RESULTS Fourteen of 29 patients with PNF in the head and neck presented with sphenoid dysplasia. All 14 patients had their PNF located in the periorbital region. Increased locoregional CSF collections were seen in almost all of these patients. Besides glioma of the optical nerve or hamartomas in the cerebrum and cerebellum, there were no other tumours found. Surgical treatment varies from simple excision to excessive debulking of the PNF, reconstruction of the orbit and even enucleation. CONCLUSION Although sphenoid dysplasia is uncommon in NF-1 patients, early recognition is important to prevent facial disfigurement and vision loss. Clinicians should be aware that abnormalities in the periorbital region and especially vertical dystopia might be the first sign of sphenoid dysplasia. Performing a CT or black-bone MR scan would be the next step to confirm or exclude sphenoid dysplasia and abnormal CSF dynamics.
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Affiliation(s)
- B F M Rijken
- Department of Plastic and Reconstructive Surgery, Erasmus University Medical Center, Rotterdam, the Netherlands.
| | | | - I M J Mathijssen
- Department of Plastic and Reconstructive Surgery, Erasmus University Medical Center, Rotterdam, the Netherlands
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Ahmedou AB, Mohamed Amine M, Youssef O, Sami R, Abada R, Mohamed R, Mohamed M, Meriem R, Mehdi K. A rare cause of cervical swelling: Solitary plexiform neurofibroma. Ann Med Surg (Lond) 2021; 64:102225. [PMID: 33786168 PMCID: PMC7988485 DOI: 10.1016/j.amsu.2021.102225] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2021] [Revised: 03/10/2021] [Accepted: 03/10/2021] [Indexed: 11/30/2022] Open
Abstract
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.
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Affiliation(s)
- Ahmed Brahim Ahmedou
- ENT, Head and Neck Surgery Department, Ibn Rochd University Hospital, Faculty of Medicine and Pharmacy, Hassan II, Casablanca, Morocco
| | - Mennouni Mohamed Amine
- ENT, Head and Neck Surgery Department, Ibn Rochd University Hospital, Faculty of Medicine and Pharmacy, Hassan II, Casablanca, Morocco
| | - Oukessou Youssef
- ENT, Head and Neck Surgery Department, Ibn Rochd University Hospital, Faculty of Medicine and Pharmacy, Hassan II, Casablanca, Morocco
| | - Rouadi Sami
- ENT, Head and Neck Surgery Department, Ibn Rochd University Hospital, Faculty of Medicine and Pharmacy, Hassan II, Casablanca, Morocco
| | - Redallah Abada
- ENT, Head and Neck Surgery Department, Ibn Rochd University Hospital, Faculty of Medicine and Pharmacy, Hassan II, Casablanca, Morocco
| | - Roubal Mohamed
- ENT, Head and Neck Surgery Department, Ibn Rochd University Hospital, Faculty of Medicine and Pharmacy, Hassan II, Casablanca, Morocco
| | - Mahtar Mohamed
- ENT, Head and Neck Surgery Department, Ibn Rochd University Hospital, Faculty of Medicine and Pharmacy, Hassan II, Casablanca, Morocco
| | | | - Karkouri Mehdi
- Pathology Department, Centre IBN ROCHD, Casablanca, Morocco
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Ndiaye L, Ndiaye AÏ, Foba ML, Sankalé AA. [Management of cervico-cephalic plexiform neurofibromas: About 35 cases]. ANN CHIR PLAST ESTH 2020; 65:306-312. [PMID: 32295731 DOI: 10.1016/j.anplas.2020.03.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2019] [Revised: 03/13/2020] [Accepted: 03/23/2020] [Indexed: 11/16/2022]
Abstract
OBJECT Plexiform neurofibroma is a characteristic lesion of Von Recklinghausen's disease. Conservative surgery is the most widely adopted treatment. However, it is very challenging because of its hemorrhagic nature and the infiltrative aspect of the lesions. The aim of this study was to evaluate our management. PATIENTS AND METHOD A retrospective study over 16 years was realized and during this period 35 patients with neurofibroma with cervico-facial location were included. RESULTS There were 18 men and 17 women with an average age of 23 years (3-50 years). The familial form was found in 9% of patients. Aesthetic discomfort was noted in all patients and functional impairment only occurred in 10% of patients. The NFP was localized at the hemiface in 11 cases, periorbital in 6 cases, naso-labial in 5 cases, scalp in 4 cases, jugal in 4 cases and cervico-chin in 5 cases. Size of the lesions averaged 11.6cm (4-45cm). Eighteen patients (51.4%) were operated including 10 by modeling resection, 05 cervico-facial lifting and 3 complete resections. Complication rate was 28% dominated by disunion wound. The average number of procedures was 1.6 (1 to 5). After 3 years average follow-up, aesthetic et functional results was assessed as good over 75 per cent of patients. CONCLUSION Cervico-facial plexiform neurofibromas is challenging. Conservative surgery should be the gold standard and long time follow-up is recommended.
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Affiliation(s)
- L Ndiaye
- Service de chirurgie plastique reconstructrice et esthétique, hôpital Aristide Le Dantec, 30, avenue Pasteur, Dakar, Sénégal.
| | - A Ï Ndiaye
- Service de chirurgie plastique reconstructrice et esthétique, hôpital Aristide Le Dantec, 30, avenue Pasteur, Dakar, Sénégal
| | - M L Foba
- Service de chirurgie plastique reconstructrice et esthétique, hôpital Aristide Le Dantec, 30, avenue Pasteur, Dakar, Sénégal
| | - A A Sankalé
- Service de chirurgie plastique reconstructrice et esthétique, hôpital Aristide Le Dantec, 30, avenue Pasteur, Dakar, Sénégal
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Bouimetarhan L, Bellamlih H, En-Nafaa I, Fenni JE, Amil T, Radouane B. [Plexiform cervical neurofibroma: about a case]. Pan Afr Med J 2018; 30:41. [PMID: 30167068 PMCID: PMC6110549 DOI: 10.11604/pamj.2018.30.41.14446] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2017] [Accepted: 04/03/2018] [Indexed: 11/16/2022] Open
Abstract
Le neurofibrome plexiforme est une tumeur bénigne rare des nerfs périphériques aux dépens des cellules conjonctives du périnevre. Il est pathognomonique de la neurofibromatose de type 1 (NF1 ou maladie de Von Recklinghausen). L'IRM est d'une grande aide au diagnostic de cette pathologie. La confirmation anatomopathologique est parfois nécessaire en particulier en dehors d'un contexte évocateur d'une NF1. Nousrapportonsl'observation d'une petite fille atteinte de neurofibrome plexiforme cervical révélateur d'une neurofibromatose Type 1.
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Affiliation(s)
- Lamiae Bouimetarhan
- Service de Radiologie, Hôpital Militaire d'Instruction Mohammed V, Université Mohammed V, Rabat, Maroc
| | - Habib Bellamlih
- Service de Radiologie, Hôpital Militaire d'Instruction Mohammed V, Université Mohammed V, Rabat, Maroc
| | - Issam En-Nafaa
- Service de Radiologie, Hôpital Militaire d'Instruction Mohammed V, Université Mohammed V, Rabat, Maroc
| | - Jamal El Fenni
- Service de Radiologie, Hôpital Militaire d'Instruction Mohammed V, Université Mohammed V, Rabat, Maroc
| | - Touria Amil
- Service de Radiologie, Hôpital Militaire d'Instruction Mohammed V, Université Mohammed V, Rabat, Maroc
| | - Bouchaib Radouane
- Service de Radiologie, Hôpital Militaire d'Instruction Mohammed V, Université Mohammed V, Rabat, Maroc
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Es Seddiki A, Rkain M, Messaoudi S, Benhadou H, Benajiba N. [A rare cause of cervical swelling in a child: Solitary plexiform neurofibroma]. Arch Pediatr 2015; 22:1276-8. [PMID: 26520581 DOI: 10.1016/j.arcped.2015.09.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2015] [Revised: 01/20/2015] [Accepted: 09/14/2015] [Indexed: 10/22/2022]
Abstract
Plexiform neurofibroma is a rare benign tumor of the peripheral tissue cells developed in the perineurium. Often considered pathognomonic of neurofibromatosis type 1 (NF1 or von Recklinghausen disease), it can be solitary without NF1, especially in children. The diagnosis is essentially pathological and treatment is primarily surgical to avoid malignant degeneration. We report on a case of cervical solitary plexiform neurofibroma discovered in a 9-year-old child.
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Affiliation(s)
- A Es Seddiki
- Service de pédiatrie, CHU Mohamed VI, Oujda, Maroc.
| | - M Rkain
- Service de pédiatrie, CHU Mohamed VI, Oujda, Maroc
| | - S Messaoudi
- Service de pédiatrie, CHU Mohamed VI, Oujda, Maroc
| | - H Benhadou
- Service de chirurgie pédiatrique, CHU Mohamed VI, Oujda, Maroc
| | - N Benajiba
- Service de pédiatrie, CHU Mohamed VI, Oujda, Maroc
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Bachelet JT, Combemale P, Devic C, Foray N, Jouanneau E, Breton P. [Management of craniofacial type 1 neurofibromatosis]. ACTA ACUST UNITED AC 2015; 116:209-14. [PMID: 26194627 DOI: 10.1016/j.revsto.2015.06.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2015] [Revised: 06/07/2015] [Accepted: 06/15/2015] [Indexed: 11/27/2022]
Abstract
Type I neurofibromatosis (NF) is the most common autosomal dominant disease. It concerns one in 3000 births, the penetrance is close to 100% and 50% of new cases are de novo mutations (17q11.2 chromosome 17 location). Cranio-maxillofacial region is concerned in 10% of the cases, in different forms: molluscum neurofibroma, plexiform neurofibroma, cranio-orbital neurofibroma, parotido-jugal neurofibroma, cervical neurofibroma. These lesions have different prognosis depending on the craniofacial localization: ocular functional risk, upper airway compressive risk, nerve compression risk, aesthetic and social impact. The maxillofacial surgeon in charge of patients with type I NF should follow the patient from the diagnosis and organize the different surgical times in order to take care about the different issues: vital, functional and aesthetic. We describe the treatment of facial localizations of type 1 NF as it is done at the University Hospital of Lyon and at the Rhône-Alpes-Auvergne neurofibromatosis reference center.
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Affiliation(s)
- J T Bachelet
- Service de chirurgie maxillofaciale, centre hospitalier Lyon-Sud, chemin du Grand-Revoyet, 69495 Pierre-Bénite, France.
| | - P Combemale
- Centre de compétence neurofibromatoses Rhône-Alpes-Auvergne, CLCC Léon-Bérard, 69008 Lyon, France
| | - C Devic
- Unité Inserm 1052, centre de recherche en cancérologie Lyon-Est, centre Léon-Bérard, bâtiment Cheney-D, 69008 Lyon, France
| | - N Foray
- Unité Inserm 1052, centre de recherche en cancérologie Lyon-Est, centre Léon-Bérard, bâtiment Cheney-D, 69008 Lyon, France
| | - E Jouanneau
- Multidisciplinary Skull Base Unit, Department of Neurosurgery B, Neurological Hospital Pierre-Wertheimer, hospices civils de Lyon, 59, boulevard Pinel, 69677 Lyon cedex, France
| | - P Breton
- Service de chirurgie maxillofaciale, centre hospitalier Lyon-Sud, chemin du Grand-Revoyet, 69495 Pierre-Bénite, France
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Niddam J, Bosc R, Suffee TM, Le Guerinel C, Wolkenstein P, Meningaud JP. Treatment of sphenoid dysplasia with a titanium-reinforced porous polyethylene implant in orbitofrontal neurofibroma: Report of three cases. J Craniomaxillofac Surg 2014; 42:1937-41. [DOI: 10.1016/j.jcms.2014.08.004] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2014] [Revised: 06/23/2014] [Accepted: 08/13/2014] [Indexed: 11/30/2022] Open
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Chaudhry IA, Morales J, Shamsi FA, Al-Rashed W, Elzaridi E, Arat YO, Jacquemin C, Oystreck DT, Bosley TM. Orbitofacial neurofibromatosis: clinical characteristics and treatment outcome. Eye (Lond) 2011; 26:583-92. [PMID: 22193879 DOI: 10.1038/eye.2011.336] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
PURPOSE To report clinical observations and surgical management in a large series of patients with orbitofacial neurofibromatosis type 1 (OFNF). PATIENTS AND METHODS Patients were identified and medical records reviewed for demographic data, ophthalmologic examinations, surgical interventions, and procedure outcome to create a retrospective, non-comparative case series of patients with OFNF seen at one medical centre over a 23-year period. RESULTS Sixty patients with OFNF (31 females and 29 males; mean age, 14 years) were followed for an average of 5.7 years. Presenting signs and symptoms included eyelid swelling in all patients, ptosis in 56 (93.3%), proptosis in 34 (56.6%), dystopia or strabismus in 30 (50%), and decreased visual acuity in 50 (83.3%). Surgical intervention included ptosis repair in 54 (90%; mean 1.6 surgical procedures), facial and orbital tumour debulking in 54 (90%; mean 2.3 surgeries), and canthoplasty in 28 (46.6%) patients. Eleven patients required enucleation or exenteration of a blind eye. CONCLUSION Patients with OFNF often require multiple procedures to preserve vision, prevent additional disfigurement, and achieve cosmetic rehabilitation. Patients need regular ophthalmological monitoring given the potential for progressive visual and cosmetic consequences.
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Affiliation(s)
- I A Chaudhry
- The King Khaled Eye Specialist Hospital, Al-Aruba Street, Riyadh, Saudi Arabia.
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[Orbitotemporal facial involvement in type 1 neurofibromatosis (NF1)]. Neurochirurgie 2010; 56:257-70. [PMID: 20303131 DOI: 10.1016/j.neuchi.2010.02.021] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2009] [Accepted: 12/17/2009] [Indexed: 11/24/2022]
Abstract
Plexiform neurofibromas of the orbit, sometimes extending to the temporal region and the face, are considered to be a rare but devastating and disfiguring complication of neurofibromatosis type 1. The first symptoms appear in infancy and the involvement of the orbit and the face is present in nearly all children after the age of 5. The disease is unilateral in most cases but can exceptionally involve both sides of the face. Progressive deformation of the orbital frame due to the expanding plexiform neurofibroma and buphthalmos occurs in a large proportion of cases. The associated sphenoidal dysplasia, which is thought to be, according to the most recent hypothesis, genetically determined, will inescapably increase the burden to the orbital content, cause pulsating proptosis and will endanger noble structures, finally resulting in loss of vision. Using the Jackson classification, the authors report their personal series of 22 cases (19 operated). Until now, there has been no effective medical treatment for plexiform neurofibroma and surgery remains the standard care for these patients. Controversies remain about the timing of the first operation and today most multidisciplinary teams involving plastic, maxillofacial, ophthalmologic, and neurosurgeons favor early intervention to try to minimize the secondary deformation of the orbital and facial skeleton. A number of cases of plexiform neurofibromas are illustrated within the three Jackson groups and treatment results of the rare elephantiasis neuromatosa cases are presented. Special techniques such as preoperative embolization of heavily vascularized plexiform neurofibroma are also discussed.
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Mouhsine A, Chaoui I, El Hassani M, Chakir N, Jiddane M. [Neurofibroma of the cranial vault in a patient with neurofibromatosis type 1]. JOURNAL DE RADIOLOGIE 2009; 90:1087-1088. [PMID: 19752814 DOI: 10.1016/s0221-0363(09)73250-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
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Jeblaoui Y, Neji B, Haddad S, Mnif D, Hchicha S. [Difficulties of the management of head and neck neurofibromatosis]. ANN CHIR PLAST ESTH 2006; 52:43-50. [PMID: 17137698 DOI: 10.1016/j.anplas.2006.09.006] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2006] [Accepted: 09/22/2006] [Indexed: 11/30/2022]
Abstract
INTRODUCTION Neurofibromatoses represent a group of 7 diseases having the same cutaneous signs due to a common embryologic origin. The types 1 and 2 are the most frequent and the most studied. Neurofibromatosis type 1 (NF1) or Von Recklinghausen's neurofibromatosis is an autosomal dominantly inherited disease, whose prevalence is 1/4500. The cranio-orbitotemporal lesions exist in 1 to 10% of the cases. Neurofibromatosis type 2 (NF2) is also an autosomal dominantly inherited disease, but is ten times less frequent than the NF1 and is characterized by bilateral vestibular schwannomas (former acoustic neurinomas). The purpose of this work was to detail the clinical features, highlighting the diagnostic and therapeutic difficulties. MATERIAL AND METHODS Nine patients managed between 1990 and 2005 were reviewed retrospectively. Eight patients were found carrier of NF1 and one patient carrier of NF2 according to the diagnostic criteria of the 1988's National Institute of Health consensus. RESULTS Five women and four men were managed; patient age varied between 13 and 62 years and the mean age was 26 years. Surgical resection of the tumor was carried out among 8 patients with bone reconstruction of the orbit on 3 patients and cutaneous expansion on one other. The results are difficult to appreciate especially that the surgery was iterative. However, all our patients were satisfied with the result and we noted recurrence in a patient presenting a retro-auricular tumor, which filled the external auditory canal requiring a further surgery. The patient having NF2 was treated by neurosurgery and showed a good result. DISCUSSION The NF1 manifestations are extremely variable. Facial neurofibromatoses are difficult to control given the presence of soft tissues infiltration and the associated osseous dysplasia. The results are modest and recurrence is frequent. Cancer risks and the disease's completely unpredictable evolution urge a regular and multidisciplinary patient follow-up.
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Affiliation(s)
- Y Jeblaoui
- Service d'otorhinolaryngologie et de chirurgie maxillofaciale, CHU La Rabta, 1007 Tunis, Tunisie.
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