Atypical Neurofibroma Masquerading an Odontogenic Cyst-A Case Report

Abstract

Neurofibroma is a benign tumor characterized by perineural fibroblast proliferation. It is common in the head and neck region but rare in the oral cavity. Most of these lesions are asymptomatic but sometimes may be associated with pain and paraesthesia. Neurofibromas with atypical features are quite rare and only a few cases are reported in literature. Here is a case of a female patient presented with pain and swelling in the anterior maxilla, which was clinically diagnosed as a periapical cyst. Radiographic evaluation of the lesion revealed dilated incisive canal and a Nasopalatine duct cyst was suspected. The patient was advised to take antibiotics for one week. The symptoms were sustained in the follow-up visit and an incision biopsy was made. Microscopic examination revealed pleomorphic spindled and round cells. Immunohistochemistry was performed to identify the origin of these pleomorphic cells. Based on the histopathological examination, special staining, and immunohistochemistry, we concluded the diagnosis as neurofibroma with atypical features. The current case emphasizes the significance of clinical, radiological, histopathological, and immunohistochemical evaluation of oral lesions. The presence of atypical features in Neurofibroma must be considered cautiously as as it is more prone to progress into Malignant Peripheral Nerve Sheath Tumor (MPNST).