Solitary neurofibroma of the floor of the mouth: rare localization at lingual nerve with intraoral excision
Abstract Background Neurofibromas (NF) are benign tumors of the peripheral nerves that are composed of Schwann cells, perineural-like cells and fibroblasts. The differential diagnosis for a solitary intraneural variant of neurofibroma arising in the floor of the mouth is broad and includes a submand...
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| Language: | English |
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BMC
2019-08-01
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| Series: | BMC Oral Health |
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| Online Access: | http://link.springer.com/article/10.1186/s12903-019-0888-0 |
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| author | Elyette Broly Benoît Lefevre Dominique Zachar Hilal Hafian |
| author_facet | Elyette Broly Benoît Lefevre Dominique Zachar Hilal Hafian |
| author_sort | Elyette Broly |
| collection | DOAJ |
| description | Abstract Background Neurofibromas (NF) are benign tumors of the peripheral nerves that are composed of Schwann cells, perineural-like cells and fibroblasts. The differential diagnosis for a solitary intraneural variant of neurofibroma arising in the floor of the mouth is broad and includes a submandibular gland neoplasm and adenopathy, among others. The intraoral approach is the best choice for a medium-sized lesion. Case presentation We report a rare case of a solitary neurofibroma of the floor of the mouth in a 31-year-old male. The patient consulted the dental emergency department for acute pain of the left mandible. Systematic clinical examination revealed the presence of a mass in the left mouth floor. The panoramic x-ray was not conclusive and the magnetic resonance imaging (MRI) revealed a well-defined soft tissue lesion with homogenous isosignal intensity on the T1-weighted image, high intensity signal on the T2-weighted image and heterogeneous enhancement following contrast-enhancement on the T1-weighted Fast Sat image. The surgical excision of the soft-tissue neoplasm was accomplished by an intraoral approach. The specimen was sent for histopathologic analysis and Immunohistochemical studies which confirmed the diagnosis of a myxoid predominant intraneural solitary neurofibroma. Conclusion The diagnosis of neurofibroma was confirmed by histopathological evaluation and immunohistochemical studies which also excluded other entities in the histopathologic differential diagnosis including schwannoma and a malignant peripheral nerve sheath tumor among other. Localized (solitary) neurofibromas most often occur as sporadic lesions, however; diagnosis of a solitary neurofibroma prompts clinical evaluation to exclude the remote possibility of neurofibromatosis. The purpose of this case report is to raise awareness of the uncommon presentation of neurofibroma and to document the successful management of such a lesion using an intraoral approach. |
| first_indexed | 2024-12-19T17:48:10Z |
| format | Article |
| id | doaj.art-a60aaa0e99aa4be9abc73271de58a571 |
| institution | Directory Open Access Journal |
| issn | 1472-6831 |
| language | English |
| last_indexed | 2024-12-19T17:48:10Z |
| publishDate | 2019-08-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Oral Health |
| spelling | doaj.art-a60aaa0e99aa4be9abc73271de58a5712022-12-21T20:11:59ZengBMCBMC Oral Health1472-68312019-08-011911810.1186/s12903-019-0888-0Solitary neurofibroma of the floor of the mouth: rare localization at lingual nerve with intraoral excisionElyette Broly0Benoît Lefevre1Dominique Zachar2Hilal Hafian3Faculté d’odontologie, Université Reims Champagne ArdenneFaculté d’odontologie, Université Reims Champagne ArdennePôle de Biologie Médicale et Pathologie, Hôpital Robert Debré, Centre Hospitalier UniversitaireFaculté d’odontologie, Université Reims Champagne ArdenneAbstract Background Neurofibromas (NF) are benign tumors of the peripheral nerves that are composed of Schwann cells, perineural-like cells and fibroblasts. The differential diagnosis for a solitary intraneural variant of neurofibroma arising in the floor of the mouth is broad and includes a submandibular gland neoplasm and adenopathy, among others. The intraoral approach is the best choice for a medium-sized lesion. Case presentation We report a rare case of a solitary neurofibroma of the floor of the mouth in a 31-year-old male. The patient consulted the dental emergency department for acute pain of the left mandible. Systematic clinical examination revealed the presence of a mass in the left mouth floor. The panoramic x-ray was not conclusive and the magnetic resonance imaging (MRI) revealed a well-defined soft tissue lesion with homogenous isosignal intensity on the T1-weighted image, high intensity signal on the T2-weighted image and heterogeneous enhancement following contrast-enhancement on the T1-weighted Fast Sat image. The surgical excision of the soft-tissue neoplasm was accomplished by an intraoral approach. The specimen was sent for histopathologic analysis and Immunohistochemical studies which confirmed the diagnosis of a myxoid predominant intraneural solitary neurofibroma. Conclusion The diagnosis of neurofibroma was confirmed by histopathological evaluation and immunohistochemical studies which also excluded other entities in the histopathologic differential diagnosis including schwannoma and a malignant peripheral nerve sheath tumor among other. Localized (solitary) neurofibromas most often occur as sporadic lesions, however; diagnosis of a solitary neurofibroma prompts clinical evaluation to exclude the remote possibility of neurofibromatosis. The purpose of this case report is to raise awareness of the uncommon presentation of neurofibroma and to document the successful management of such a lesion using an intraoral approach.http://link.springer.com/article/10.1186/s12903-019-0888-0Solitary neurofibromaLingual nerveMagnetic resonance imagingS-100 proteinEMA |
| spellingShingle | Elyette Broly Benoît Lefevre Dominique Zachar Hilal Hafian Solitary neurofibroma of the floor of the mouth: rare localization at lingual nerve with intraoral excision BMC Oral Health Solitary neurofibroma Lingual nerve Magnetic resonance imaging S-100 protein EMA |
| title | Solitary neurofibroma of the floor of the mouth: rare localization at lingual nerve with intraoral excision |
| title_full | Solitary neurofibroma of the floor of the mouth: rare localization at lingual nerve with intraoral excision |
| title_fullStr | Solitary neurofibroma of the floor of the mouth: rare localization at lingual nerve with intraoral excision |
| title_full_unstemmed | Solitary neurofibroma of the floor of the mouth: rare localization at lingual nerve with intraoral excision |
| title_short | Solitary neurofibroma of the floor of the mouth: rare localization at lingual nerve with intraoral excision |
| title_sort | solitary neurofibroma of the floor of the mouth rare localization at lingual nerve with intraoral excision |
| topic | Solitary neurofibroma Lingual nerve Magnetic resonance imaging S-100 protein EMA |
| url | http://link.springer.com/article/10.1186/s12903-019-0888-0 |
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