Title: Neurofibroma Arising In the Parotid Gland- A Rare Case Report

Authors: Shagufta Qadri, Divya Rabindranath, Azka Anees Khan, Senthil P.

 DOI:  http://dx.doi.org/10.18535/jmscr/v4i1.15

Abstract

Neurofibromas of salivary gland are very rare and account for only 0.4% of all salivary gland neoplasms.  Plexiform type of neurofibroma is predominantly seen in a scenario of neurofibromatosis 1 association, but solitary plexiform neurofibroma has also been occasionally reported. We present a report of this variant in a 17 year old male who presented with a slow growing painless swelling in the right pre auricular region for 8 months duration. Microscopic examination and immunostaining of the tumor confirmed the diagnosis of plexiform neurofibroma. We report this case in order to emphasize the importance of correctly recognizing this rare entity due to several reasons; including the difficulty in its complete excision, and a potential for malignant transformation in 10% cases. Therefore, correct diagnosis and a timely treatment with follow up are a necessity for this tumor.

References

1.            Seifert G , Miehlke A , Haubrich J , e t al. Pathology, Diagnosis, Treatment, Facial Nerve Surgery . Stuttgart, Germany: Georg Thieme Verlag 1986: 171– 301.

2.            R Rajendran. Plexiform neurofibroma of the gingival: Report of a rare case. J oral and maxillofacial pathol  2006; 10: 28-30.

3.            Hemlata T Kamra, Sunita S Dantkale, Khushboo Birla, Pankaj W Sakinlawar, Paresh H Bharia. Plexiform neurofibroma in the floor of the mouth but without neurofibromatosis-1: a rare case report. Ecancer 2013; 7: 313

4.            LS Marocchio, MC Pereira, CT Soares, DT Oliveira. Oral neurofibroma not associated with neurofibromatosis type I: Case Report. J Oral Sci, 2006; Vol 48; No.3; 157-160. 

5.            Prada CE, Rangwala FA, Martin LJ, Lovell AM, Saal HM, Schorry EK, et al. Pediatric plexiform neurofibromas: impact on morbidity and mortality in neurofibromatosis type 1. J Pediatr 2012; 160; 461–7.

6.            Keel SB, Rosenberg AE. Soft tissue pathology of the head and neck. In: Pilch BZ. ed. Head and Neck Surgical pathology. Philadelphia: Lippincott Williams and Wilkins 2001;417-8.

7.            McDaniel RK. Benign mesenchymal neoplasms in surgical pathology of the salivary glands, Volume 25, Ed: Ellis GL, Auclair PL,Gnepp DR. (Philadelphia: WB Saunders) 1991:496–97.

8.            Ellis GL, Auclair PL . Tumors of the salivary glands . In: Ellis GL, Auclair PL , eds. Atlas of Tumor Pathology . Third series, fascicle 17 . Washington, DC : Armed Forces Institute of Pathology 1996 : 318 – 24 .

9.            Speight PM, Barrett AW . Salivary gland tumours. Oral Dis 2002 ; 8 : 229 – 40 .

10.        Ledesma-Montes C, Garces-Ortiz M . Salivary gland tumours in a Mexican sample. A retrospective study. Med Oral 2002 ; 7 : 324 – 30 .

11.        Huson, Susan Mary; Hughes, Richard Anthony Cranmer . The neurofibrom-atoses: a pathogenetic and clinical overview. London: Chapman & Hall. 1994:1.3.2:9. 

12.        Muir D, Neubauer D, Lim IT, Yachnis AT, Wallace MR. "Tumorigenic properties of neurofibromin-deficient neurofibroma Schwann cells.". Am J Pathol 2003; 158(2): 501-13. 

13.        Zheng H, Chang L, Patel N, Yang J, Lowe L, Burns DK, Zhu Y. "Induction of Abnormal Proliferation by Nonmy-elinating Schwann Cells Triggers  Neurofibroma Formation".Cancer Cell  2008; 13 (2): 117–28. 

14.        LinJ, Martel W. Cross sectional image of peripheral nerve sheath tumors: Characteristic sign on CT, MR imaging and sonography . Am J Roentgenol  2001; 176: 75–82.

15.        Hope DG, Mulvihill J.  Malignancy in neurofibromatosis. Adv Neurol 1981; 29: 33–56.

16.        Aribandi M, Wood WE, Elston DM, et al. CT features of plexiform neurofibroma of the submandibular gland.  Am J Neuroradiol  2006; 27:126-8.

17.        Needle MN, Cnaan A, Dattilo J, et al. Prognostic signs in the surgical management of plexiform neurofibroma: the Children’s Hospital of Philadelphia experience, 1974-1994. J Pediat1997; 131: 678-82.

Corresponding Author

Dr Divya Rabindranath

24D, Vinayagar koil street, Nalvar layout, Rathinapuri,

Coimbatore-641027, Tamilnadu, India.

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