2025 BMJ case reports

Solitary intraoral pyogenic granuloma in neurofibromatosis type 1: diagnostic conundrum.

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BMJ case reports Vol. 18 (7) • Jul 2025

Neurofibromatosis Type 1 (NF1) is a genetic disorder characterised by benign tumours and cutaneous lesions, including neurofibromas. This case report describes a boy in his early 10s with NF1 who presented with an oral swelling initially suspected to be a neurofibroma. However, histopathological analysis revealed the lesion to be a solitary pyogenic granuloma. The patient's clinical presentation included multiple cafe-au-lait spots and neurofibromas, consistent with NF1. MRI of jaws suggested a non-infiltrative benign mass, and excisional biopsy confirmed the diagnosis of pyogenic granuloma, with negative S100 staining excluding neurofibroma. This case report presents a pyogenic granuloma in an NF1 patient and emphasises the importance of differentiating these lesions from neurofibromas. Accurate diagnosis is crucial for appropriate management and follow-up, given the potential for neurofibromas to undergo malignant transformation. Regular monitoring and multidisciplinary care are recommended.

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