Solitary intraosseous neurofibroma of the mandible: Report of an extremely rare histopathologic feature

Rare nonsyndromic recurrent solitary gingival neurofibroma in an older adult

BACKGROUND

Neurofibromas are benign peripheral nerve sheath tumors usually featured with neurofibromatosis type 1 syndrome. Recurrent gingival neurofibromas have been rarely reported in the periodontal literature, particularly affecting elderly patients.

METHODS AND RESULTS

A 70-year-old man with a pale, rubbery, and painless thickening along the facial/buccal gingiva of the mandibular right canine and first premolar. Ten years prior, the patient had undergone excision of a neurofibroma within the same region. The patient denied a history of cutaneous disease or neurofibromatosis. Histopathologic and immunostaining of the excised lesion confirmed the diagnosis as a recurrent gingival neurofibroma.

CONCLUSIONS

With cases of suspected recurrent neurofibroma, attending practitioners should consult with an oral pathologist whether the primary lesion had exhibited tumor cells to the surgical specimen margin. Preoperative use of a cone beam computed tomography scan may enhance determination of tumor depth. Clinicians should also carefully weigh the decision for conservative excision of gingival neurofibromas and greater risk of recurrence versus performing a somewhat wider extirpation and possible formation of a mucogingival defect.

KEY POINTS

What are important clinical considerations when performing a gingival biopsy? Gingival neurofibromas may be associated with an increased risk for recurrence owing to decisions for tissue-sparing excision and prevention of a mucogingival defect; supplemental use of cone beam computed tomographic scans may provide greater appreciation of tumor depth. What is a reasonable length of time of postoperative assessment for gingival neurofibromas? Patients who have undergone surgical removal of a gingival neurofibroma should undergo yearly surveillance for at least 10 years. What is a key limitation to this case study? Preoperatively, attending clinicians should consult with an oral pathologist to ascertain whether a primary lesion had manifested tumor cells to the surgical margin. Conservative gingival resection of a neurofibroma may promote recurrence.

Clinical, Radiographic, and Tumor Characteristics of Solitary Intra-Osseous Neurofibroma of Jaws- A Systematic Review

Neurofibroma is a benign tumor of the peripheral nervous system affecting Schwann cells as well as neural sheath cells. It is usually considered as a component of Von Recklinghausen's disease, but solitary lesions have also been reported, though not very frequently. It is mostly reported on the skin. In the head and neck region, trigeminal nerve and the cervical nerves are frequently affected; in the oral cavity, tongue is the most commonly affected site. Intra-osseous neurofibromas of the oral cavity are extremely rare and only 22 cases have been reported in the last two decades. The present review is an attempt to know if there is any clinical or radiological feature that can assist in the diagnosis of solitary intra-osseous neurofibroma of the jaws? The literature was reviewed from 01.01.2000 to 05.06.2022 exclusively for case reports, case series, and reviews using the keywords: neurofibroma; neurinoma, maxilla; mandible; jaws, single; solitary; one. Search engines: PubMed Central, Lilac, and Science Direct were used by applying the Boolean operator "OR" and "AND". The review has been submitted for registration in PROSPERO (receipt 340775).

An Unusual Intraosseous Swelling of the Jaw: Two Rare Case Reports

Neurofibroma is the most common type of peripheral nerve neoplasm arising from a mixture of cell types, including schwann cells and perineurial fibroblasts. We report two unusual cases where patients presented with intraosseous swelling of the jaw. A complete examination followed by Imaging and histopathological examination were advised. Imaging showed ill-defined radiolucency in one case and well defined corticated radiolucency with soap-bubble appearance in the other case. Biopsy with adjuvant immunohistochemistry revealed features suggestive of neurofibroma. Both cases were managed surgically. The second case in the male patient, also showed multiple recurrences and subsequent transformation into atypical neurofibroma. In spite of being a benign tumor, neurofibroma is locally aggressive. Commonly found in soft tissues of the body, neurofibromas are rare in the head and neck region. But the intraosseous location of this tumor in the mandible is an exceptional case.

Solitary intraosseous neurofibroma in the mandible mimicking a cystic lesion: A case report and review of literature

BACKGROUND

Neurofibromas are benign tumors of a neurogenic origin. If these tumors occur without any other signs of neurofibromatosis, they are classified as isolated neurofibromas. Neurofibromas in the oral cavity mostly occur within soft tissues, indicating that solitary intraosseous neurofibromas in the mandible are rare. Due to the absence of specific clinical manifestations, early diagnosis and treatment of these tumors are difficult to achieve.

CASE SUMMARY

A 37-year-old female patient visited our hospital due to numbness and swelling of the gums in the right lower molar area that had persisted for half a month. The patient's overall condition and intraoral examination revealed no significant abnormalities. She was initially diagnosed with a cystic lesion in the right mandible. However, after a more thorough examination, the final pathological diagnosis was confirmed to be neurofibroma. Complete tumor resection and partial removal of the right inferior alveolar nerve were performed. As of writing this report, there have been no signs of tumor recurrence for nine months following the surgery.

CONCLUSION

This case report discusses the key features that are useful for differentiating solitary intraosseous neurofibromas from other cystic lesions.

Solitary Neurofibroma of Mandible in a 2-Year-Old Child: A Rare Case Report and Review of Literature

Solitary intraosseous neurofibromas of mandible are very rare and only 40 cases are documented. This case report presents one of the youngest documented case of solitary neurofibroma of mandible, in a 2-years old male child. The tumour was symptomatic and presented as a swelling over right posterior region of mandible. The patient underwent conservative excision under general anaesthesia. The inferior alveolar nerve was preserved. Histopathology was suggestive of benign nerve sheath tumour. Immunohistochemistry showed moderate S-100 and strong CD34 positivity. Postoperative healing was uneventful. This report also reviews forty previously reported cases of solitary intraosseous neurofibromas of the mandible.

Benign Pancreatic Neurofibroma with Malignant Imaging Features: A Case Report and Literature Review

Pancreatic neurofibroma is a very rare benign neurogenic tumor unrelated to neurofibromatosis type 1 (NF-1). As the volume increases, it has the risk of malignant transformation. The surgical prognosis of pancreatic neurofibroma is good, but its preoperative imaging features are very similar to those of malignant tumors, which may affect the formulation of treatment plans. This article reports a case of giant neurofibroma of the pancreas with contrast-enhanced ultrasound (CEUS) as one of the diagnostic methods and discusses the tumor’s preoperative clinical features, laboratory examinations, and imaging features.

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.

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.

Multiple recurrent neurofibromas in the abdominal wall: A case report

BACKGROUND

Neurofibroma can be a clinical manifestation of neurofibromatosis, which is a benign neurogenic tumor that occurs sporadically. Neurofibromas in the abdomen usually appear in the retroperitoneal space. Reports on neurofibromas in the abdominal wall are rare, and multiple recurrent neurofibromas in this area have not yet been reported.

CASE SUMMARY

This is a case of a 73-year-old man who suffered from multiple recurrent neurofibromas in the abdominal wall for 16 years and received 13 surgical treatments.

CONCLUSION

We need to pay due attention to its treatment, and primary surgery should be designed thoroughly.