Dental apseyi taklit eden bir patoloji: fasiyal pleksiform nörofibroma

Year 2019, Volume: 36 Issue: 1, 28 - 32, 02.01.2019

Buket Ceylan Çalık Yılmaz , Alev Alaçam

https://doi.org/10.17214/gaziaot.408607

Abstract

Tanıtım: Fasiyal pleksiform nörofibroma (FPN) yüzün nadir görülen
tümörlerinden biridir. Kranial sinirler veya üst servikal sinirleri içerir ve
lezyon düşük oranda malign transformasyon gösterir. Özellikle çocukluk çağında
izlenir. FPN aynı zamanda nörofibromatozis tip 1 (NF1) için tanı
kriterlerinden biridir. NF1 yaygın ve multisistemik bir sendromdur. Bu olgu
raporunda, çocuk hastada FPN ile birlikte izlenen NF1'in oral ve radyografik bulgularının
sunulması amaçlandı.

Olgu Bildirimi: Dokuz yaşındaki NF1
tanılı erkek hasta sol mandibuler posterior bölgede yemek yerken gelişen ağrı
şikayetiyle kliniğimize başvurdu. Ekstraoral muayenede ‘cafe-au-lait’ lekeleri
ve sol yanakta ağrısız şişlik görüldü. Şişliğin palpasyonunda solucan torbası
hissi alındı. İntraoral muayenede sol bukkal mukozada şişlik, alveoler kemikte
genişleme ve bütün süt molar dişlerde çürükler olduğu saptandı. Periapikal
radyografta 75 numaralı dişte enfeksiyon ve buna bağlı olarak distal kök rezorpsiyonu
belirlendi. Panoramik radyografta mandibuler ramusta incelme, mandibuler kanal
ağzında genişleme, mandibuler çentikte derinleşme ve koronoid proçeste ve
kondil boynunda uzama izlendi. Alınan anamnez ve yapılan klinik ve radyografik
muayene sonucunda yanaktaki şişliğin dental apseye bağlı olmadığı bununla
birlikte bunun bir FPN lezyonu olduğu belirlendi. Hastanın gereken diş
tedavileri yapıldı ve rutin kontrol randevuları oluşturuldu.

Sonuç: Çocuk diş
hekimliğinde fasiyal asimetrilerin klinik olarak değerlendirilmesinde dental
patolojiler dışında kalan oluşumlara FPN’nin de sebep olabileceği akılda
tutulmalıdır.

Keywords

Fasiyal asimetri, nörofibromatozis, neurofibrom, pleksiform

A pathology mimicking dental abscess: facial plexiform neurofibroma

Abstract

Introduction: Facial plexiform neurofibroma (FPN) is a rare
tumor appearing on the face. It involves cranial or upper cervical nerves, and
lesions show malign transformation at a low rate. It is especially seen in childhood.
FPN is also a component of the diagnostic criteria for neurofibromatosis type 1
(NF1). NF1 is a common and multi-systemic syndrome. This case report aimed to
present the oral and radiographic findings of FPN and NF1 diagnosed in a child
patient.

Case Report: A 9-year-old
male patient diagnosed with NF1 applied to our clinic complaining from pain
during eating in the left mandibular posterior region. Extraoral examination
showed ‘cafe-au-lait’ blots and an asymptomatic swelling on the left cheek.
Worm-bag-sensation was felt on palpation of the swelling. Intraoral examination
showed swelling of the buccal mucosa, enlargement in the alveolar ridge and caries
on all primary molar teeth. Periapical radiograph showed signs of infection and
distal root resorption in tooth number 75. Panoramic radiograph revealed
thinning of the mandibular ramus, dilatation of the mandibular foramen,
deepening of the mandibular notch and prolongation of the coronoid process and condylar
neck. The collected anamnesis together with the clinical and radiographical
findings suggested that the swelling on the cheek was not due to a dental
abscess; rather it was due to an FPN lesion. The patient's treatment was done
and routine check-up appointments were arranged.

Conclusion: During clinical evaluation, it should be
kept in mind that FPN may be one of the reasons of facial asymmetries of
non-odontogenic pathologies in pediatric dentistry.

Keywords

Facial asymmetry, neurofibromatosis, neurofibroma, plexiform

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