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Abstract
RÉSUMÉ
Le neurofibrome est une tumeur bénigne du tissu conjonctif des nerfs périphériques, souvent associée à une neurofibromatose de type I mais pouvant être isolée. La localisation solitaire au niveau du sinus maxillaire est rare. Nous rapportons deux cas afin de discuter leur particularité diagnostique et thérapeutique. Deux patients âgés de 16 et 22 ans, un homme et une femme, tous avec des antécédents d’algies dentaires, ont consulté pour une tuméfaction jugale évoluant depuis plusieurs mois. L’examen clinique retrouvait une masse indolore, ferme, fixée au plan profond associée à une lésion endo-buccale. L’imagerie (TDM) avait montré une lésion hypodense au sein du sinus maxillaire avec une lyse osseuse. La prise en charge consistait à une exérèse chirurgicale complète de la lésion avec pose de prothèse. L’examen anatomopathologique a confirmé le diagnostic de neurofibrome dans tous les cas. Le neurofibrome du sinus maxillaire est une tumeur rare et d’expression clinique non spécifique. Son diagnostic est difficile, reposant sur l’histologie. L’exérèse chirurgicale reste le traitement de choix, avec nécessité d’une surveillance prolongée en raison du risque de récidive ou de transformation maligne.
ABSTRACT
Neurofibroma is a benign tumor of the connective tissue of peripheral nerves, often associated with type I neurofibromatosis but sometimes occurring in isolation. Solitary localization in the maxillary sinus is rare. We report two cases to discuss their diagnostic and therapeutic particularities. Two patients aged 16 and 22 years, one male and one female, both with a history of dental pain, consulted for a cheek swelling that had been evolving for several months. Clinical examination revealed a painless, firm mass fixed to the deep planes, associated with an intraoral lesion. Imaging (CT scan) showed a hypodense lesion within the maxillary sinus with bone lysis. Management consisted of complete surgical excision of the lesion with prosthetic reconstruction. Histopathological examination confirmed the diagnosis of neurofibroma in all cases. Maxillary sinus neurofibroma is a rare tumor with non-specific clinical presentation. Diagnosis is challenging and relies on histology. Surgical excision remains the treatment of choice, with the need for long-term follow-up due to the risk of recurrence or malignant transformation.
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References
- 1. Boedeker CC, Ridder GJ, Kayser G, Schipper J, Maier W. Solitary neurofibroma of the maxillary sinus and pterygopalatine fossa. Otolaryngol Head Neck Surg. 2005;133(3):458‑459.
- 2. Cegarra-Navarro MF, Díaz-Manzano JA, Viviente-Rodríguez E, Iniesta-Alcázar J. Solitary neurofibroma of the maxillary sinus. Acta Otorrinolaringol Esp. 2011;62(5):395‑397.
- 3. Ellis GL, Abrams AM, Melrose RJ. Intraosseous benign neural sheath neoplasms of the jaws. Report of seven new cases and review of the literature. Oral Surg Oral Med Oral Pathol. 1977;44(5):731‑743.
- 4. Ferner RE, O’Doherty MJ. Neurofibroma and schwannoma. Curr Opin Neurol. 2002;15(6):679‑684.
- 5. Hillstrom RP, Zarbo RJ, Jacobs JR. Nerve sheath tumors of the paranasal sinuses: electron microscopy and histopathologic diagnosis. Otolaryngol Head Neck Surg. 1990;102(3):257‑263.
- 6. Hirao M, Gushiken T, Imokawa H, Kawai S, Inaba H, Tsukuda M. Solitary neurofibroma of the nasal cavity: resection with endoscopic surgery. J Laryngol Otol. 2001;115(12):1012‑1014.
- 7. Nao EEM, Tall A, Ndiaye M, Ndiaye C, Diouf MS, Thiam A, et al. Solitary neurofibroma of the maxillary sinus. Ann Otolaryngol Chir Cervicofac. 2009;126(5‑6):256‑258.
- 8. Poupard RJ, Mintz S. Solitary intrabony neurofibroma of the maxilla. J Oral Maxillofac Surg. 1997;55(7):768‑772.
- 9. Sharma P, Narwal A, Rana AS, Kumar S. Intraosseous neurofibroma of maxilla in a child. 2009 cité le 13 septembre 2025;27(1):62. Disponible sur: https://journals.lww.com/jped/fulltext/2009/27010/intraosseous_neurofibroma_of_maxilla_in_a_child.14.aspx.
- 10. Tall A, N’diaye C, Diom E-S, Thiam I. Solitary neurofibroma originating from the posterior nasal septum: Transnasal endoscopic resection. Eur Ann Otorhinolaryngol Head Neck Dis. 2015;132(4):223‑225.
- 11. Yang XC, Chen L. Unusual paranasal sinus solitary neurofibroma and literature review. BJR Case Rep. 2023;9(5):20230025.
- 12. Yap D, Fox H, Addams-Williams J. Unusual Case of a Proptosed Eye: Isolated Right Maxillary Neurofibroma. Case Rep Pathol. 2016;2016:4294729
References
1. Boedeker CC, Ridder GJ, Kayser G, Schipper J, Maier W. Solitary neurofibroma of the maxillary sinus and pterygopalatine fossa. Otolaryngol Head Neck Surg. 2005;133(3):458‑459.
2. Cegarra-Navarro MF, Díaz-Manzano JA, Viviente-Rodríguez E, Iniesta-Alcázar J. Solitary neurofibroma of the maxillary sinus. Acta Otorrinolaringol Esp. 2011;62(5):395‑397.
3. Ellis GL, Abrams AM, Melrose RJ. Intraosseous benign neural sheath neoplasms of the jaws. Report of seven new cases and review of the literature. Oral Surg Oral Med Oral Pathol. 1977;44(5):731‑743.
4. Ferner RE, O’Doherty MJ. Neurofibroma and schwannoma. Curr Opin Neurol. 2002;15(6):679‑684.
5. Hillstrom RP, Zarbo RJ, Jacobs JR. Nerve sheath tumors of the paranasal sinuses: electron microscopy and histopathologic diagnosis. Otolaryngol Head Neck Surg. 1990;102(3):257‑263.
6. Hirao M, Gushiken T, Imokawa H, Kawai S, Inaba H, Tsukuda M. Solitary neurofibroma of the nasal cavity: resection with endoscopic surgery. J Laryngol Otol. 2001;115(12):1012‑1014.
7. Nao EEM, Tall A, Ndiaye M, Ndiaye C, Diouf MS, Thiam A, et al. Solitary neurofibroma of the maxillary sinus. Ann Otolaryngol Chir Cervicofac. 2009;126(5‑6):256‑258.
8. Poupard RJ, Mintz S. Solitary intrabony neurofibroma of the maxilla. J Oral Maxillofac Surg. 1997;55(7):768‑772.
9. Sharma P, Narwal A, Rana AS, Kumar S. Intraosseous neurofibroma of maxilla in a child. 2009 cité le 13 septembre 2025;27(1):62. Disponible sur: https://journals.lww.com/jped/fulltext/2009/27010/intraosseous_neurofibroma_of_maxilla_in_a_child.14.aspx.
10. Tall A, N’diaye C, Diom E-S, Thiam I. Solitary neurofibroma originating from the posterior nasal septum: Transnasal endoscopic resection. Eur Ann Otorhinolaryngol Head Neck Dis. 2015;132(4):223‑225.
11. Yang XC, Chen L. Unusual paranasal sinus solitary neurofibroma and literature review. BJR Case Rep. 2023;9(5):20230025.
12. Yap D, Fox H, Addams-Williams J. Unusual Case of a Proptosed Eye: Isolated Right Maxillary Neurofibroma. Case Rep Pathol. 2016;2016:4294729