Sir, in this letter we highlight the need for a follow-up to ensure complete resolution of an intra-oral swelling following treatment of presumed dentoalveolar pathology. A 35-year-old lady presented to the maxillofacial department recently with a 15-year history of a swelling growing slowly in the hard palate on the left side.

The upper left first premolar tooth had been root filled 15 years ago as the cause of the swelling was thought to be dental in origin. At the time she was reassured that the swelling would go away some months following her root canal therapy. Recently she changed GDP and was re-referred to our maxillofacial department for the same palatal swelling.

An OPT (Fig. 1) was taken which showed a root filled and crowned upper left first premolar tooth. Biopsy of the lesion confirmed the swelling to be a plexiform neurofibroma. Because of the link to neurofibromatosis1 she was further investigated with a magnetic resonance scan (Fig. 2) that revealed a similar mass in the cranial cavity. This was extra-axial with a connection to the inner table of the skull. MRI was used to confirm this.

Figure 1
figure 1

An OPT taken at presentation indicating the root filled upper left first premolar

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Figure 2
figure 2

An MRI indicating the cranial lesion

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The patient is undergoing a joint approach with our neurosurgical colleagues with regards to her cranial and oral lesions.

We would like to take this opportunity to remind readers of the importance of careful follow up of any unresolved swelling thought to be related to dental pathology.