Solitary neurofibroma of the gingiva with prominent differentiation of Meissner bodies: a case report

Abstract

BackgroundOral neurofibromas are peripheral nerve sheath tumors, similar to schwannomas. Histological variations in oral neurofibromas are relatively uncommon.Case presentationHere, we present a case of unique variation in the observed characteristics of a neurofibroma, with no relation to neurofibromatosis type-1 or von Recklinghausen disease of the skin. The neurofibroma was observed in the right mandibular gingiva of a 32-year-old Japanese woman. Histologically, it differed from conventional neurofibromas in that the tumor was composed of a mixture of fine fibrillary collagen in sheets and/or cords of neoplastic Schwann cells containing numerous clusters of Meissner bodies. Histologically, these bodies were in contact with neoplastic Schwann cells. The Meissner bodies were immunopositive for S-100 protein, neuron-specific enolase, and vimentin, but were negative for calretinin. CD34-positive spindle cells were observed around the Meissner bodies. No recurrence or signs of other tumors have been observed in the patient for 5 years after tumor resection.ConclusionTo the best of our knowledge, no formal descriptions of sporadic, solitary neurofibromas containing numerous Meissner bodies occurring in the oral cavity are available in literature. We believe that an uncommon proliferation of Meissner bodies, as seen in the present case, may result from aberrant differentiation of neoplastic Schwann cells.

Neurofibromas of the oral and maxillofacial complex: A 48‐year retrospective study

“…Neurofibromas are microscopically commonly characterized as non‐encapsulated neoplasms, containing interlacing bundles of elongated cells with wavy nuclei. The cells are intimately associated with wire‐like collagen strands and the stroma is dotted with mast cells and lymphocytes . Similarly to these findings, most cases in the present study were not well delimited and had a predominantly myxoid stroma.…”

“…Oral neurofibromas may occur as solitary (sporadic) or multiple lesions associated or not with neurofibromatosis type I (von Recklinghausen disease of the skin) . Although these neoplasms may be associated with syndromes, the majority of lesions are sporadic, as observed herein, where, from a total of 24 cases, only three (12.5%) were associated with neurofibromatosis type I.…”

“…Neurofibromas are the most common type of peripheral nerve neoplasm, characterized by a proliferation of Schwann cells, perineural cells, and endoneural fibroblasts . These neoplasms represent about 29% of the neural lesions that occur in the oral and maxillofacial complex …”

Expression of S-100, EMA, CD34 and presence of mast cells in eight oral neurofibromas, and a review of 127 cases of the literature

“…Approximately 25% of neurofibromas are found in the head and neck region, and rare involvement of the oral cavity has been reported in sites such as the lips, tongue, buccal mucosa and alveolar ridge. Neurofibromas usually present as a superficial, painless nodule with nonspecific clinical symptoms and resemble fibrous hyperplasia, fibromas, or lipomas (7,23,24,28) .…”

“…The S-100 protein marker has been widely used in the identification of Schwann cells and is important for the diagnosis of neural sheath tumors (30) . However, the differential diagnosis of neurofibromas from other lesions (schwannomas, leiomyomas, and myofibromas) requires the use of additional immunohistochemical stains and histochemical reagents to identify the several components of the tumor (1,11,24,26) .…”