Case report
Solitary giant neurofibroma of the neck subjected to photodynamic therapy: case study
1 Department of Oral and Maxillofacial Surgery, School of Dentistry, Al-Yarmouk University College, Baghdad, Iraq
2 Unit of Oral and Maxillofacial Surgery, UCL Eastman Dental Institute, London, UK
3 Department of Oral and Maxillofacial Surgery, University of Mosul, Mosul, Iraq
4 Department of Surgery, UCL Medical School, London, UK
5 Leeds Institute of Molecular Medicine, University of Leeds, Leeds, UK
6 Department of Surgery, AL-Yarmouk University College, Baghdad, Iraq
7 UCLH Head and Neck Centre, Euston Street, London, United Kingdom
Head & Neck Oncology 2012, 4:30 doi:10.1186/1758-3284-4-30
Published: 6 June 2012Abstract
Photodynamic therapy (PDT) - the fourth modality - has been successfully used in the management of early and advanced pathologies of the head and neck. We studied the effect of this modality on a giant solitary neurofibroma of the neck. A 70-year-old Caucasian female presented with left neck pain and disfigurement associated with slight shortness of breath and dysphagia. Examination revealed a large mass in the neck with no neurovascular compromise. Magnetic resonance imaging (MRI) reported a heterogeneously enhancing mass extending from the left angle of the mandible to the base of the neck. A core biopsy was performed and histopathological examination revealed a disorganised array of peripheral nerve fascicles. The patient elected to receive photodynamic therapy as the primary intervention. The multi-disciplinary meeting approved the treatment plan. The photosensitizing agent was mTHPC (0.15 mg/kg), which was systemically administered 96-hours prior to ultrasound (US)-guided light delivery to the mass, which was undertaken under general anaesthesia. Recovery was uneventful.Post-PDT follow-up showed that the patient’s pain, dysphagia and shortness of breath issues had improved. The disfigurement of the neck caused by the mass was no longer a problem. Three months post-PDT, MRI revealed a significant reduction in the neurofibroma size. PDT was proven as a successful primary intervention for this pathology. However, higher evidence-based studies are required before this therapy can be proposed as a replacement to any of the other conventional therapies.
