A Case of Solitary Neurofibroma in Outer Surface of Nose

Shahin Abdollahi-Fakhim,Reza Piri,Mohammad Naghavi-Behzad,Hojjat Hosseinpour-Feizi,Saman Rezaeian

doi:10.15171/jarcm.2016.039

Abstract

Solitary neurofibroma is a benign tumor originating from Schwann cells in peripheral nerves. In an investigation of 430000 pathologic samples, only 6 cases of neurofibroma had been reported in nose and paranasal sinuses. Present patient was a 15-year-old girl with left-sided nasal and malar mass, whose CT scan and MRI showed a non-circumscribed solid mass with total thickness affecting outer part of nose in left side as well as surface and deep soft tissue. The mentioned mass underwent excision by sub-labial incision and open rhinoplasty keeping infra-orbit nerve intact. Pathologic investigation of samples showed adipose fibroblast and skeletal muscle fibers with proliferation of spindle-shaped cells and staining was negative for GFAP and positive for S-100 which represents diagnosis of neurofibroma. Main differential diagnoses of benign tumors of paranasal sinuses and nasal cavity include neurofibroma, fibroma, leiomyomas, papilloma, and schwannoma. After resection tumor should be precisely monitored, since there is malignant transformation possibility in solitary neurofibromas.

Highlights

Solitary neurofibroma is a benign tumor originating from Schwann cells in peripheral nerves
Neurofibromas and schwannomas are classified as benign tumors and both are believed to arise from Schwann cells.[1,2]
Neurofibromas arising from the nose and paranasal sinuses are rare.[7]

Summary

Introduction

Peripheral nerve sheath tumors include neurofibromas, schwannomas and neurogenic sarcomas. Neurofibromas and schwannomas are classified as benign tumors and both are believed to arise from Schwann cells.[1,2] Solitary neurofibroma is a benign, slow-growing, circumscribed, but not encapsulated tumor This tumor essentially is composed of Schwann cells arising from a peripheral nerve and usually affects skin or subcutaneous tissue.[3,4] Neurofibroma is generally presented in background of Von. Recklinghausen’s disease, but it can appear solitarily.[5] This tumor is usually found in the head and neck and the flexor surfaces of the extremities. Patient did not complain of face or nose pain, headache, epistaxis, nasal discharge, or adenoid. She mentioned a history of a blunt trauma to nose which had not been followed-up. Patient was regularly monitored and during a year after surgery no complications of surgery or symptoms of tumor recurrence were observed

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Conclusion