A silent tumor of the gingiva: An unusual case report and surgical management with 1 year follow-up
A 25-year-old female patient was referred to the department of Periodontology with a gingival swelling in the upper right back region. The lesion was an incidental finding by her dentist at a routine dental check-up. A history suggested the swelling had been present for approximately 6 months. This swelling had not caused any pain and no other symptoms were reported by patient. The medical history was non-contributory and the patient did not smoke or drink alcohol.\nOn local examination, the lesion was smooth, firm with sessile base, non-ulcerated, painless, with normal color measuring 4 mm × 10 mm, extending from the mesial of maxillary right first premolar to the mesial of maxillary right first molar involving the marginal, papillary, and attached gingiva []. Intra oral periapical radiograph showed a mild crestal bone loss between 13 and 14 and between 14 and 15 [].\nBased on texture, differential diagnosis of granuloma or a possible fibroma was made. A punch biopsy of the lesion was conducted under local anesthesia and the specimen was submitted to routine histopathological analysis [Figures and ].\nHistopathologically, hematoloxylin, and eosin stained biopsy sections showed spindle-shaped cells, with fusiform or wavy comma-shaped nuclei distributed on a background of delicate connective tissue matrix [].\nHaving confirmed the occurrence of a neurofibrona, a complete exploration was made. There was no relevant family history and no evidence of NF, such as café-au-lait macules or freckling in the axillary and inguinal regions. No lisch nodules were detected during an ophthalmological study. The patient showed normal physical and mental development. With the above clinical and histological findings, the diagnosis of solitary neurofibroma of the gingiva was made and complete excision of the lesion was planned.\nUnder local anesthesia complete excision was achieved using no. 15 blade. The growth was carefully dissected and separated from the underlying tissues [Figures and ]. The excised specimen was almost 0.5 cm × 1 cm in size []. The bed of the lesion was examined for remnants, hemostasis was achieved and Coe pack was placed [Figures and ]. The post-operative period was uneventful. The patient was kept on a constant follow-up [] and after 12 months, there were no signs or symptoms derived from the lesion [].