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Facial hematoma induced spontaneously or by minimal trauma in a facial plexiform neurofibroma: a case report and literature review

Journal of the Korean Association of Oral and Maxillofacial Surgeons / Journal of the Korean Association of Oral and Maxillofacial Surgeons, (P)2234-7550; (E)2234-5930
2023, v.49 no.3, pp.152-156
https://doi.org/10.5125/jkaoms.2023.49.3.152
Sang Min Lee (Department of Oral and Maxillofacial Surgery, School of Dentistry, Jeonbuk National University)
Dae Ho Leem (Department of Oral and Maxillofacial Surgery, School of Dentistry, Jeonbuk National University)

Abstract

Plexiform neurofibroma is a rare benign tumor and a special subtype of neurofibromatosis 1. This report is a literature review with a case of patient with facial hemorrhage observed at the site of neurofibroma removal in the right lower face due to minor trauma. Through PubMed search, using terms ((facial hematoma) OR (facial bleeding)) AND (neurofibromatosis), 86 articles were identified, and five related articles (six patients) were finally selected. Of the six patients, two had previously undergone embolization. However, as a result, all patients received open surgery to remove hematomas. The hemostatic methods mentioned were vascular ligation (five patients), hypotensive anesthesia (two patients), and postoperative blood transfusion (four patients). In conclusion, spontaneous or minimally traumatic bleeding is possible in neurofibromatosis patients. In most cases, it can be resolved by vascular ligation under hypotensive anesthesia. Optionally, prior embolization and supplementary tissue adhesive may be used.

keywords
Neurofibromatosis, Neurofibroma, Hematoma, Angiopathy, Microtrauma

Journal of the Korean Association of Oral and Maxillofacial Surgeons