Abstract Neurofibroma is a benign peripheral nerve sheath tumor that rarely affects the thyroid gland. Primary thyroid neurofibroma is extremely uncommon, with only a few histologically confirmed cases reported globally. We present the case of an 11-year-old female who presented with a painless midline neck swelling progressively increasing over 6 months. The swelling moved with deglutition and clinically resembled a thyroid lesion. Radiological evaluation with ultrasonography and contrast-enhanced computed tomography suggested a multinodular goiter, and cytology revealed nodular goiter with fibrosis. Surgical excision of the right thyroid lobe was performed under general anesthesia. Intraoperatively, most of the right lobe was replaced by a firm gray-white mass. Histopathological examination showed spindle-shaped cells with wavy nuclei in a myxoid-collagenous stroma and entrapped thyroid follicles. Immunohistochemistry revealed strong S-100 positivity, focal CD-34 positivity, and epithelial membrane antigen negativity, confirming the diagnosis of primary thyroid neurofibroma. The postoperative recovery was uneventful, and no recurrence was noted. This case highlights the diagnostic difficulty of thyroid neurofibroma, which can mimic common thyroid pathologies. Correlation of clinical, radiological, and histopathological findings is vital for accurate diagnosis and optimal management.
Watts et al. (Wed,) studied this question.