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 |
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 |