Abstract:

INTRODUCTION: Neurofibromas located in head and neck constitute approximately twenty five percent of all neurofibromas and six percent of those are observed in oral cavity. Involvement of tongue, hard and soft palate, gingiva, mandibula, tongue base and rarely floor of the mouth are observed in oral cavity. (1) Nonsyndromic solitary neurofibroma located in the flow of the mouth in oral cavity are observed quite low, and the purpose of this case report is to attract attention to the diagnosis and treatment of this rare disease. CASE: Thirty-two year-old male patient applied to our clinic with swelling under his tongue.  In physical examination, a mucosa covered mass was determined that is approximately 3 cm in size and pushing the tongue upwards. In the examination with bimanual palpation, mobile, painless and hard mass was observed to extend from the floor of the mouth to submandibular region. Surgical treatment was recommended to the patient. The excision was decided to be performed under general anesthesia and through intraoral route. Diagnosis of neurofibroma was finalized since immunohistochemical study observed to be S-100 (+). No findings suggesting neurofibramatosis or multiple endocrine neoplasia syndrome were determined in the repeated systemic examination. There were no cafe au lait spots on the body and family history for neurofibramatosis was negative. CONCLUSION: Localized neurofibromas are usually solitary, non-syndromic. It is usually detected in the age range of 20-30 years and shows intraneural, non-infiltrative type growth. The presence of multiple neurofibromas is important in NF1. When considering neurofibroma pre-diagnosis, the presence of cafe au lait spots should be sought in the general medical examination of the patient and a detailed resume story should be taken from the patient. Concomitant skeletal anomalies, presence of mucosal multiple neurofibromas, multiple endocrine neoplasia may require genetic analysis. Non-syndromic neurofibroma is thought to originate from Schwann cells or from perineural fibroblasts. The treatment of peripheral nerve sheath tumors is surgery. It is important for this very rare disease to be considered among pre-diagnoses for patients who have applied with swelling on the floor of their mouth, and especially to be recognized that this mass, which has a malignant transformation risk, may be associated with syndromic diseases.

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