The development of a neurofibroma in the temporal and parotid regions of the facial nerve is rare. We report a case occurring in a 32-year-old male, where the initial presentation was a parotid mass. Cytologically this was initially thought to be a pleomorphic adenoma. However, the diagnosis was then changed to a schwannoma and finally a neurofibroma after complete excision of the lesion. The case illustrates how fine needle aspiration cytology under ultrasound guidance, and even histological examination of an incision biopsy can sometimes fail to give the correct diagnosis. In this case magnetic resonance imaging was used to help plan definitive surgery.
Different selection criteria lead to significantly different numbers of patients being considered suitable for hearing preservation surgery. Consensus and agreed selection criteria would help set patient expectations, refine candidate selection, and facilitate the comparison of outcomes across centers.
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