Voluminous Solitary Neurofibroma of the Nasosinus Cavities in an Undermedicalized Context: Reflection on a Case Collected in Bamako

Abstract

Neurofibroma is a benign tumor of the connective tissue developed mainly at the expense of the endoneurium of the peripheral nerves. Histologically, there are two types of neurofibroma: plexiform and solitary. The objective of this work was to report a case of solitary nasosinusal neurofibroma in order to discuss diagnostic and therapeutic difficulties in a developing country. BA aged 17, with no known pathological history, was admitted to the service for a left nasal obstruction which had been evolving for about 4 years. The endonasal examination found a congestive mass, not bleeding on contact, filling the entire left nasal fossa pushing back the nasal septum on the right. Computed tomography showed a heterogeneous dense tissue process with cystic areas, filling the left nasal fossa with extension to the posterior sinuses, left maxilla. The patient was operated under general anesthesia via the left paralateronasal route. The tumor was difficult to cleave but not friable and not bleeding. The histological examination concludes to a neurofibroma. Conclusion: Solitary neurofibromas are uncommon and remain poorly understood. Literature data, rare, do not answer all the questions.