A curious submandibular mass associated with the mylohyoid muscle

Abstract

Background: Neurofibromas are commonly associated with neurofibromatosis type 1 but may also present in isolation as solitary neurofibromas. Solitary intramuscular neurofibromas are a rare occurrence. We describe a case of a submandibular neurofibroma associated with the nerve to the mylohyoid muscle. Case presentation: A patient presented with a solitary, painless submandibular mass. On imaging, the mass was heterogeneously enhancing and indistinguishable from the mylohyoid muscle. Intraoperatively, the mass appeared smooth, well-circumscribed, encased by the mylohyoid muscle, and associated with a small nerve, likely the nerve to the mylohyoid. Histology and immunohistochemical analysis confirmed the mass as a neurofibroma. Conclusion: To our knowledge, this is the first confirmed case of a solitary intramuscular neurofibroma arising in association with the mylohyoid nerve and muscle. This case demonstrates that relatively common tumors can occur in uncommon locations.

Keywords

• Neurofibroma
• Head and neck neoplasm
• Mylohyoid muscle
• Mylohyoid nerve
• Submandibular tumor