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       XXVII Annual Congress of the Iranian Society of Ophthalmology        بـیــست و هفتمین کنــگــره سـالیـانه انـجـمـن چـشـم پـزشـکی ایـــران
مقاله Abstract


Title: Isolated neurofibroma of the supraorbital nerve: presentation of an uncommon tumor
Author(s): Bahram Eshraghi, Mojgan Nikdel, Hadi Ghadimi
Presentation Type: Poster
Subject: Ophthalmic Plastic and Reconstructive Surgery
Others:
Presenting Author:
Name: Hadi Ghadimi
Affiliation :(optional) Eye Research Center, Farabi Eye Hospital, Tehran University of Medical Sciences, Tehran, Iran
E mail: hadi.ghadimi@gmail.com
Phone: 44222113
Mobile: 09128180965
Purpose:

To report a rare case of isolated neurofibroma of the supraorbital nerve in a patient without systemic neurofibromatosis type 1 (NF-1), which is scarcely observed in clinical practice.

Methods:

A 22-year old woman presented with complaint of puffiness of medial side of her right upper lid since a year ago. An irregular, non-tender, mobile mass was palpated in the superomedial aspect of the orbit with soft tissue consistency. CT scan only showed soft tissue swelling in the superomedial orbit. Superior orbitotomy was performed under general anesthesia. The mass was a non-encapsulated, gray, rubbery lesion, and further dissection revealed it to be composed of three elongated sausage-shaped portions. Following the course of the lesion, the mass was found to be continued by the distal part of the supraorbital nerve. An incisional biopsy of the mass was performed. Complete resection was not feasible because of the involvement of the trunk of the supraorbital nerve and possibility of extensive frontal anesthesia associated with severe damage of this nerve.

Results:

The histopathologic exam and immunohistochemical (IHC) study confirmed the diagnosis of neurofibroma. IHC revealed positive staining with S-100, CD99 and epithelial membrane antigen (EMA), but negative staining with glial fibrillary acid protein (GFAP). The patient underwent comprehensive investigation for criteria of NF-1, but there were no positive findings. Family history was also negative for NF-1. On follow up exam three months after the operation, the mass was unchanged and there was hypoesthesia in the forehead, within the sensory distribution of the supraorbital nerve. MRI with gadolinium showed an anterior orbital mass which enhanced the contrast material.

Conclusion:

Isolated neurofibroma of orbit, while rarely observed, should be considered in the differential diagnosis of orbital masses, and due to its potential for malignant transformation, requires careful follow up.

Attachment: 173NF Poster IRSO96.pptx





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