J Korean Assoc Oral Maxillofac Surg.  2023 Jun;49(3):152-156. 10.5125/jkaoms.2023.49.3.152.

Facial hematoma induced spontaneously or by minimal trauma in a facial plexiform neurofibroma: a case report and literature review

• Lee SM
• Leem DH

• KMID: 2544318
• DOI: http://doi.org/10.5125/jkaoms.2023.49.3.152

Abstract

Plexiform neurofibroma is a rare benign tumor and a special subtype of neurofibromatosis 1. This report is a literature review with a case of patient with facial hemorrhage observed at the site of neurofibroma removal in the right lower face due to minor trauma. Through PubMed search, using terms ((facial hematoma) OR (facial bleeding)) AND (neurofibromatosis), 86 articles were identified, and five related articles (six patients) were finally selected. Of the six patients, two had previously undergone embolization. However, as a result, all patients received open surgery to remove hematomas. The hemostatic methods mentioned were vascular ligation (five patients), hypotensive anesthesia (two patients), and postoperative blood transfusion (four patients). In conclusion, spontaneous or minimally traumatic bleeding is possible in neurofibromatosis patients. In most cases, it can be resolved by vascular ligation under hypotensive anesthesia. Optionally, prior embolization and supplementary tissue adhesive may be used.

Keyword

Neurofibromatosis; Neurofibroma; Hematoma; Angiopathy; Microtrauma

Figure

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  Fig. 1 Clinical image on first visit. The right mandible shows swelling after a blunt trauma.

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  Fig. 2 Magnetic resonance imaging. The neurogenic tumor spans the central spinal canal and left neural foramen. The spinal cord is pressed to the right by the mass.

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  Fig. 3 Clinical image before surgery. The scar tissue from previous neurofibroma removal surgery is formed. The area around the edema is taut and bluish.

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  Fig. 4 Computed tomography (CT) view. A large hematoma collection with a diameter of about 5 cm was confirmed in the buccal and submandibular space.

Reference

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