Solitary neurofibroma of the palate mimicking mucocele: A rare case report

Neurofibroma (NF) is a benign tumour of the peripheral nervous system which is rare in head and neck region. Head and neck NF are mostly located in the soft tissue and rarely seen intraosseously. These may present either as solitary lesions or as part of the generalised syndrome of neurofibromatosis or von Recklinghausen's disease of the skin. The intraosseous ones are most commonly seen as solitary lesions, rather than part of neurofibromatosis. The following report describes a unique case of a solitary neurofibroma of the maxilla without generalised syndrome of neurofibromatosis in a male patient.

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“…The aggressive nature makes initial monitoring of patients necessary, clinically presenting as neurofibroma only 11 12…”

Section: Discussionmentioning

confidence: 99%

Solitary neurofibroma of maxilla: a rare clinical entity

Grewal

Saini²,

Gautam³

et al. 2020

BMJ Case Rep

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“…Neurofibromas, on the other hand, have spindle-shaped tumor cells that are less cytoplasmic than schwannomas, and their nuclei are small, oval in shape, and do not exhibit a palisade pattern. Because of the fibrous components found between the cells, the tumor cells appear wavy [ 1 , 11 ]. In addition to this arrangement of cells, S-100 protein positivity is a major differentiator between neurofibromas and schwannomas, with neurofibromas being positive for S-100 protein, but at a lower rate than schwannomas [ 1 ].…”

Section: Discussionmentioning

confidence: 99%

“…Chaubal et al [ 13 ] and Ohno et al [ 16 ] reported that CD34-positive spindle-shaped cells are found in neurofibromas but not in schwannomas. On histopathology, the myxomatous stroma is seen in neurofibromas, but not in schwannomas [ 11 ]. In addition, schwannomas often have capsules, while neurofibromas do not [ 17 ]; therefore, neurofibromas have been reported to be more likely to recur than schwannomas [ 18 ].…”

Section: Discussionmentioning

confidence: 99%

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Solitary Neurofibroma of the Hard Palate: A Case Report and Literature Review

et al. 2021

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Patient: Female, 24-year-old Final Diagnosis: Neurofibroma Symptoms: Bulging of the hard palate Medication: — Clinical Procedure: — Specialty: Dentistry • Oncology Objective: Rare disease Background: Neurofibromas are benign tumors of neurological origin caused by the proliferation of Schwann cells and fibroblasts; they often occur in the skin and nerves as a symptom of von Recklinghausen disease. Solitary neurofibromas are also known to occur on their own, but solitary development in the hard palate is extremely rare and difficult to distinguish from schwannomas. The neural origin of solitary neurofibromas is also difficult to determine intraoperatively, and there have been no reports that clearly identify the neural origin of neurofibromas in the hard palate. Case Report: We report a case of a solitary neurofibroma originating in the hard palate in a 24-year-old woman. She presented to our department with a 1.2×0.8-cm dome-shaped left palate mass. After identification of the nerve at the source, the tumor was resected under general anesthesia. Histopathology was positive for S-100 and CD34 immunostaining, as well as for Alcian blue. Eventually, the mass was diagnosed as a neurofibroma. Conclusions: Solitary neurofibromas originating in the hard palate are difficult to differentiate from other neoplastic lesions, especially schwannomas, based on clinical findings alone. Therefore, it is important to perform a biopsy and immunostaining of the biopsied specimens for S-100 and CD34. In neurofibromas, tumor cells are loose and delicate, often with wavy or serpentine nuclei, and S-100 protein-positive cells are sparser than in schwannomas. An overall pathological diagnosis should be made with regard to CD34, taking into account that schwannomas are CD34-negative and neurofibromas are CD34-positive.

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“…Neurofibromas são neoplasmas benignos de tecido nervoso não-encapsulados, sendo as neoplasias mais comuns em nervos periféricos. São derivados das células de Schwann, dos fibroblastos perineurais ou de ambos (Martorelli, 2009;Broly, 2019;Sekhar, 2019). Afetam principalmente a pele, mas lesões na cavidade oral não são incomuns e quando estas ocorrem, afetam principalmente a língua, mucosa jugal e mucosa gengival.…”

Section: Introductionunclassified

Neurofibroma intraósseo versus schwannoma, importância do diagnóstico diferencial histológico no diagnóstico definitivo: Relato de caso

Silva

Genu

Cardoso

et al. 2021

RSD

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As neoplasias de origem neurais representam 8% e 12% de todas as neoplasias de tecidos moles malignas e benignas, respectivamente. Nesse conjunto estão inseridos os tumores da bainha do nervo periférico (TBNP), um grupo relativamente raro de doenças que são classificadas de acordo com as características específicas de diferenciação, componentes celulares e matriz extracelular. Neurofibroma e schwannoma são exemplos de lesões pertencentes a esse grupo. O objetivo desse estudo é apresentar um caso clínico de uma paciente, sexo feminino, 60 anos de idade, diagnosticada com lesão central na região de corpo mandibular direito. A lesão foi descoberta após exame de rotina para reabilitação protética e, após biopsia incisional, obteve-se diagnóstico inicial de schwannoma. O tratamento proposto foi uma ressecção marginal, por meio da instalação de placa de reconstrução de 2,4mm e enucleação da lesão. Uma biopsia excisional foi então solicitada onde se obteve como diagnóstico final neurofibroma. A paciente apresentou resposta satisfatória ao tratamento, sem sinais de recidiva. Embora o diagnóstico decisivo de neurofibroma seja baseado em achados histológicos, lesões como schwannoma devem ser incluídas como diagnóstico diferencial histológico, o que pode dificultar o diagnóstico definitivo. Nesse sentido, características peculiares do schwannoma e neurofibroma, seus comportamentos imunoistoquímicos e suas semelhanças são necessários para traçar suas repercussões no estabelecimento do diagnóstico. Ainda que não haja diferença no tratamento, tais lesões podem estar associadas a síndromes diferentes, o que torna necessária sua diferenciação final, especificamente para os casos em que haja dúvida.

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Solitary neurofibroma of the palate mimicking mucocele: A rare case report

Cited by 9 publications

References 11 publications

Solitary neurofibroma of maxilla: a rare clinical entity

Solitary neurofibroma of maxilla: a rare clinical entity

Solitary Neurofibroma of the Hard Palate: A Case Report and Literature Review

Neurofibroma intraósseo versus schwannoma, importância do diagnóstico diferencial histológico no diagnóstico definitivo: Relato de caso

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