Surgical Care
Solitary oral neurofibromas are usually treated by surgical excision, depending on the extent and the site. Excision with preservation of the nerve is preferred. However, for neurofibromas associated with neurofibromatosis, surgical removal is attempted only for functional or cosmetic reasons. Surgical removal may result in recurrence, and multiple recurrences have been associated with malignant transformation. Genetic evaluation and counseling is suggested if a syndromic effect is suspected.
Consultations
Many authorities believe that any individual presenting with neurofibroma at an early age (< 20 y) should be referred for genetic studies to rule out the possibility of neurofibromatosis. Consultation with a geneticist and a family physician may be critical in establishing a diagnosis of neurofibromatosis.
Complications
A possible, although extremely rare, complication may be recurrence of the lesion. Other potential complications that may be seen are purely associated with surgical treatment and may include scarring and numbness.
Prevention
No special precaution is recommended for prevention of recurrence. Surgical excision is usually curative.
Long-Term Monitoring
Solitary neurofibromas are treated by surgical excision and exhibit very low recurrence. The patient should be instructed to report any new growth seen in the area or any abnormal sensations, such as tingling. These signs may signify a recurrence, and lesions may require repeat excision.
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Intrabony presentation of neurofibroma. Note the extensive bone destruction caused by the lesion.
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Multiple neurofibromas on the tongue.
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Solitary neurofibroma on the hard palate.
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An 11-year-old girl with an asymptomatic raised lesion on the anterior mandibular gingiva.
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Isolated palatal lesion in a 27-year-old African American woman.
