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Neurofibroma originating in the peripheral facial nerve located in the parotid gland is a very rare disease which has been reported by Maxwell(1951) and Michael(1987). This tumor must be diagnosed differently than schwannoma and neurugenic tumors. When this lesion develops in the parotid region, parotid gland tumor must be rulled out. It can be diagnosed with difficulty using aspiration, and conclusively diagnosed using histological biopsy.
This benign but clinically malignant tumor has no capsule and multiple outgrowth with bag of worms findings on palpation, which extends across the neuronal axon without degenratve changes. This rare lesion can be manifested as a part of neurofibromatosis, solitary or multiple tumor with more frequent sarcmatous degenerations than schwannoma. But schwannoma which has the characteristics of circumscribed, well-encapsulated findings, pretends to push the axon eccentrically with cystic or hemorragic degenerative changes in a solitary lesion. To excise this poorly encapsulated neurofibroma, enbloc resection containing nerve fibers in inevitable, and nerve preservation procedures are unattainable. So intraparotid facial nerve neurofibroma cannot be confirmed by preperative evaluation, and managements, whether any nerve preservation methods can be chosen or not, is very difficult and depend on size, location, and degree of the outgrowth. Until recent days, primary neurogenic tumors in peripheral facial nerve origin are almost all reported as Schwannoma except for 2 previous cases.
The authers reported on case of solitary nerofibroma originating in the buccal branch of the facial nerve. This was excised completely under microscopic magnification without any complications.
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