Solitary and complicated neurofibroma of small Bowel: A case report

• Published in: International journal of surgery case reports 2021-01, Vol.78, p.126-129
• Main Authors: Ait Ali, Hassane, Zeriouh, Brahim, Egyir Ebo, Usman, Serji, Badr, Elharroudi, Tijani
• Format: Article
• Language: English
• Subjects: Bowel neurofibroma; Case Report; Intestinal obstruction; Intussusception; Neurofibromatosis type I
• ISSN: 2210-2612; 2210-2612
• DOI: 10.1016/j.ijscr.2020.12.020

•The presentation of isolated neurofibroma of the bowel as acute intestinal intussusception is rare and preoperative diagnosis is difficult.•We report a rare case of isolated bowel neurofibroma to sensitize the medical team about this exceptional pathology and its management.•Surgical removal is the cornerstone of treatment to prevent local infiltration and malignant transformation.•A close follow-up after surgical resection is recommended because the solitary bowel neurofibromas may be the first sign of type I neurofibromatosis. Neurofibromatosis is a genetic disorder characterized by tumors and pigmentary changes on the skin, such as spots that color leans to ‘White Coffee’. Neurofibromas of the gastrointestinal tract are commonly associated with neurofibromatosis type I (NF1). Although, digestive involvement can be the single manifestation of the disease and may consequently; represent the only diagnostic element. We report here; a case of a patient admitted to the emergency department with a bowel obstruction, for which radiological investigations revealed the presence of intussusception due to an intestinal tumor. The patient underwent a bowel resection with anastomosis, and then, after being examined histologically, the result has identified an intestinal neurofibroma without evidence of malignancy. Then and on the fourth day following the surgery, the patient was discharged with good clinical improvement. The intestinal neurofibroma may be the first and the only manifestation of neurofibromatosis type I. Also, it’s uncommon to present a neurofibroma isolated from the small bowel with an intussusception, which makes the pre-surgical diagnosis very difficult. And until now, only a few case reports of these conditions have been reported. We report this uncommon clinical case of an isolated neurofibroma from the small bowel to raise awareness among the medical team about this exceptional pathology. Nevertheless, its risk of developing serious complications and malignant transformation led us to opt for earlier surgical treatment. Furthermore, it requires a close clinical follow-up to eliminate the neurofibromatosis type I or the multiple endocrine neoplasia type II.