Neurofibrosarcomas of the head and neck are uncommon. The difficulties encountered in their proper care are of such complexity that an appraisal of their clinical course and surgical management is indicated.
Since they were first described, there has been little unanimity of opinion regarding the cell origin of these tumors, and accordingly they have been called by a variety of names. Some authors1-3 have stressed their Schwannian origin and thus call them malignant schwannomas. They have also been designated by the synonyms of neurogenic sarcoma,4,5 neurosarcoma,6 and neurofibrosarcoma.7 We prefer the last term because it is well established and easily understood and because it describes the histological appearance without entering into the controversy of its cellular derivation.
The clinical appearance of neurofibrosarcomas is not diagnostic. In the area under discussion they are usually of small or medium size, resilient, smooth, and occasionally painful. Ulceration occurs only