Facial plexiform neurofibromatosis: A surgical challenge
This 18-year-old boy was brought to our out patient department by his parents with a history of progressively increasing swelling over the right side of his face since childhood.\nPhysical examination revealed a huge soft tissue swelling involving the right mandibular region and cheek, extending up to the nasolabial fold pulling down the right angle of the mouth and right eye, partially obstructing the field of vision in his right eye []. He had few neurofibromas over his trunk, axillary freckles and café au lait macules over his back. Magnetic resonance imaging (MRI) of the face excluded any intracranial extension.\nHe was taken up for reconstructive surgery and the swelling was approached through pre-auricular incision extending superiorly into the temporal area. Tumescent fluid infiltration was carried out in the tumor mass to reduce the blood loss. The tumor mass was infiltrating deeply and the tissue planes could not be defined. There was gross thickening of facial nerve in the pre-auricular region as well as its branches. Subtotal excision of tumor mass and readjustment of facial flap was carried out with reasonable post-op correction []. However, 6-monthly review in this case as well showed evidence of some regrowth.