Solitary Neurofibroma at the Base of the Tongue: A Rare Presentation

A 75-year-old man presented with a slowly growing mass at the right side of the base of the tongue for 4 months. The mass was painless initially but had become very painful during preceding 4 weeks. On examination a 3 cm diameter, oval swelling was observed at the right side of the base of the tongue. It was firm in consistency, slightly tender, non-ulcerative, and with irregular surface. A deep incisional biopsy was taken from mass under general anesthesia. Histopathology report identified the mass consistent with neurofibroma. It featured typical pallisading arrangement of fascicles of spindle-shaped cells and there was no evidence of malignancy. An absence of Verocay body and thick hyalinized vessels ruled out Schwannoma. No similar lesions were found in any other part of the patient's body. He exhibited no skin pigmentation, no hearing deficit, and no evidence suggestive of any systemic disorders that might have been attributable to the tongue base neurofibroma. His family history was also negative. Thus, a diagnosis of isolated neurofibroma of the tongue was established. The patient was advised excision of the mass but he refused and lost in follow up.