Solitary Neurofibroma in the Submental Region of a 15-Year-Old Adolescent: A Case Report and Review of Literature.
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BACKGROUND: Neurofibroma is a benign peripheral nerve sheath tumor composed of Schwann cells and fibroblasts. It may occur sporadically or as part of neurofibromatosis type 1 (NF1). Solitary neurofibroma arising in the submental region of an adolescent is extremely rare. We report a case of a solitary submental neurofibroma in a 15-year-old male and highlight its diagnostic and management implications. CASE PRESENTATION: A 15-year-old adolescent boy presented with a chronic, painless right submental swelling that had been present for one year and had enlarged over the preceding three months. Clinical examination revealed a rubbery, nontender, approximately 3×3×4 cm mass without skin changes or systemic symptoms. There was no personal or family history suggestive of NF1, neural tumors, or pheochromocytoma. Ultrasound and CT imaging showed a well-defined soft-tissue mass consistent with a benign neurogenic tumor. The mass was completely excised via a submental incision. Histopathological examination confirmed a solitary neurofibroma with Schwann cell and fibroblast proliferation within a collagen matrix, Antoni A and B patterns, and positive S-100 immunostaining, with no evidence of malignancy. The postoperative course was uneventful, and tongue and floor-of-mouth function were preserved. CONCLUSIONS: Solitary submental neurofibroma should be considered in the differential diagnosis of submental masses in adolescents, even in the absence of NF1 features. Complete surgical excision is the treatment of choice and allows definitive histopathological diagnosis. A thorough evaluation for NF1 is recommended to guide long-term management and follow-up.