Figure 1 Pre-operative panoramic radiograph revealing periapical lesion associated with tooth #31.

Figure 2 Pre-operative cone beam CT scan revealing enhanced visualization of the lesion in the longitudinal plane.

Figure 3 Post-operative cone beam CT scan after 1 year.

Figure 4 Histological staining at 20x magnification.

Figure 5 Histological staining at 60x magnification.

Table 1. Clinical, radiographic, histological and immunohistochemistry features of reported intraosseous neurofibroma of the mandible.

References

Age (yrs)

Gender

Radiographic features

Histological features

Immunohistochemistry features

Reebye 2017

 70

 F

Well-defined radiolucent region

Spindle shaped bundles of cells with wavy nuclei and admixture of predominantly inferior alveolar nerve fibers and fibrous tissue

 S-100 positive

Gujjar 20155

28

F

Homogenous radioopacity surrounded by a thin uniform radiolucent border

spindle shaped cells with wavy nuclei and collagen fibres within a myxoid stroma

S-100 positive

Jagnam 20146

62

F

Well-defined radiolucency

admixture of nerve fibers (mostly inferior alveolar nerve) and fibrous tissue; no malignancy

S-100 positive

Diechler 20117

14

M

Unilateral radiolucency

regular spindle cells with wavy, hyperchromatic nuclei and scanty cytoplasm, in a richly vascularized myxoide stroma, with presence of collagen fibers and connective tissue cells

Tumor cells: vimentin positive, neuroespecific enolase (NSE) positive and anti S-100 negative
Residual nerve fibers: S-100 positive; NSE positive

Tao 20108

16

F

Multilocular and irregular edges

spindle-shaped, aligned in a plexiform manner

S-100 positive

Depprich 20099

64

M

Little to moderate interdental loss of bone between teeth 37 and 38 

proliferative spindle cells with a stroma composed of irregular collagen fibers

S-100 positive

Vivek 20064

39

F

Well-circumscribed radiolucency

spindle shaped cells with wavy and tapered nuclei

Lack of encapsulation; S-100 positive

Apostolidis 200110

67

F

Well circumscribed and elliptical radiolucency

spindle shaped cells with wavy nuclei and collagen fibres within a myxoid matrix along with mast cells; No malignancy

Not reported

Alatli 199611

37

F

No abnormality

spindle cells arranged to form roundish foci and wavy, thin bands within fibrous connective tissue

Not reported

Ueda 199312

37

M

Oval radiolucent area

Spindle shaped cells intermingled with a delicate fibrillar stroma along with numerous mast cells

S 100 positive

Papageorge 199213

4.5

M

Unilocular, well-defined radiolucency

spindle cells with slight to moderate nuclear pleomorphism

S-100 protein and vimentin positive

Weaver 199114

22

F

Radiolucent, well-circumscribed lesion

Spindle shaped cells and flowing bundles of cellular connective tissue

S-100 positive

Polak 198915

60

M

Unilocular radiolucent area

spindle-shaped cells intermingled with a delicate fibrillar stroma along with mast cells

S-100 and anti-Leu positive

Papadopoulos 198116

15

M

Radiolucency

Neoplastic cells with ovoidal, elongated nucleus; No pleomorphism; No encapsulation

Not reported

Gnepp 198117

24

F

Non expansile, moderately well-defined unilocular radiolucent

Bundles of mildly pleomorphic spindle shaped cells in fibrous stroma

Not reported

Gnepp 198117

39

F

Well demarcated, slightly expansile, unilocular radiolucent

Interlacing bundles of elongated spindle shaped cells in fibrous stroma

Not reported

Larsson 197818

25

F

Extense bone resorption

Irregular nerve fiber strands intermingled with collagen fibers and abundant cells

Not reported

Larsson 197818

46

M

Bone destruction with slightly radiopaque areas

Spindle cell with elongated or oval nuclei forming cords

Not reported

Ellis 197719

41

F

Poorly defined multiloculated radiolucency

Slight morphologic variability in cells with no mitotic activity

Not reported

Ellis 197719

4

F

Well demarcated radiolucency

Abundance of small nerves with several enlarged nerve fascicles

Not reported

Ellis 197719

8

M

Well demarcated radiolucency with sclerotic borders

Dense, wavy tissue of collagenous type with fibers in random orientation and cells with spindle shaped nuclei with no mitotic figure

Not reported

Ellis 197719

23

F

Indistinct radiolucent-radioopaque lesion

Loose, myxomatous and fibrillary nature with more abundant mucoid matrix

Not reported

Ellis 197719

4

M

Multilocular radiolucency

Dense, wavy tissue of collagenous type with fibers in random orientation and cells with spindle shaped nuclei with no mitotic figure

Not reported

Singer 197320

30

F

Radiolucent fusiform enlargement

Interlacing cords of fusiform cells with thin tapering nuclei associated with fibrillar stroma

Not reported

Cundy 197221

55

F

Large radiolucency

spindle cells with ovoid nuclei arranged in parallel rows with intertwining fascicles

Not reported

Prescott 197022

5

M

Circumscribed radiolucent

Irregular bundles of nerve tissue and whorls with ovoid elongated and comma shaped basophilic nuclei and pale acidophilic cytoplasm

Not reported

Cassalia 19712

16

F

Multilocular radiolucency

delicate intertwining network of collagen fibres together with numerous small nerve fibrils

Not reported

Sharawy 196823

22

F

Multilocular radiolucent

Delicate connective tissue fibrils, fibroblasts and nerve tissue with few woven bone trabeculae

Not reported

Gutman 196424

5

F

Unilocular, translucent area

Spindle cells arranged in ranks or small whorls embedded in a non-cellular, collagenous, connective tissue; No signs of malignancy

Not reported

Villa 196225

2.5

M

Radiolucent lesion

Infiltrating small bands of skeletal muscle; Inferior alveolar nerve showed increase in fibrous tissue

Not reported

Caldwell 19611

2.5

M

Radiolucent lesion

Infiltrating small bands of skeletal muscle; Inferior alveolar nerve showed increase in fibrous tissue

Not reported

Johnson 195926

34

F

Radiolucent

Interlacing bundles of elongated spindle shaped cells with wavy nuclei

Not reported

Cornell 195527

65

F

Cystic character with not well defined borders

Encapsulated tumor with thick myelinic nerve filaments towards the centre

Not reported

Bruce 195428

36

M

Osteolysis in mandibular alveolus

Rows of palisaded nuclei separated by a band of fibers without nuclei

Not reported

Blackwood 195129

41

M

Large radiolucent area

Type A: parallel arrangement of cells and intercellular fibres giving a regimented appearance; Type B: loose meshwork of cells and shows the presence of numerous intercellular vacuoles or microcysts

Not reported

Goldman 194430

33

M

Large cystic lesion

Reticulated mesenchymal tissue with occasional nerve filaments. Spindle shaped cells with small nuclei arranged in bundles

Not reported