Intraparotid facial nerve plexiform neurofibroma in a child (case report)

Intraparotid facial nerve neurofibromas are benign neoplasms, extremely rare, difficult to diagnose and to manage. Only three pediatric cases have been reported in the literature. We report the 4th case of a 7-year-old child admitted for a parotid mass without facial palsy, for whom the surgical indication was the increase in volume of this mass, as well as the aesthetical impairment, the surgical exploration found the tumor attached to the lower branch of the division of the facial nerve. The excision of the mass was performed with the sacrifice of the inferior branch of the facial nerve, the trunk and the upper branch of the facial nerve was preserved, the pathological study was in favor of a plexiform neurofibroma. The patient has presented postoperatively a grade 5 facial palsy in the inferior territory of the facial nerve with a slight recovery 1 year after surgery. Even though plexiform neurofibromas in the parotid gland are extremely rare, and their diagnosis are not often primary evoked in front of any growing mass of this region, the surgeon must keep in mind the existence of these neoplasms as a differential diagnosis of a parotid tumor. •Neurofibromas are non-encapsulated tumors that grow inside the nerve that surrounds each nerve fascicle and lengthen them, locally invasive, non-metastatic, highly vascularized, and slow-growing.•Our patient is the 4th isolated case of intraparotid facial nerve plexiform neurofibroma without neurofibromatosis type 1.•Preservation of the nerve during surgery is almost impossible and its excision can lead to significant morbidity.•It is essential that the surgeon keep in mind the existence of these tumors as a differential diagnosis of a parotid tumor.