1
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Chen N, Li W, Min L, Huang Q, Bian J. Neurofibromatosis type 1 with huge intrathoracic meningoceles misdiagnosed as pleural effusion: A case report and literature review. J Cardiothorac Surg 2024; 19:303. [PMID: 38816890 PMCID: PMC11138057 DOI: 10.1186/s13019-024-02819-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2024] [Accepted: 05/25/2024] [Indexed: 06/01/2024] Open
Abstract
BACKGROUND Neurofibromatosis type 1 is a genetic disease that affects multiple organs and systems, leading to various clinical manifestations. In Neurofibromatosis type 1, rare intrathoracic meningoceles often occur alongside bone dysplasia. These meningoceles contain cerebrospinal fluid and can be mistakenly diagnosed as 'pleural effusion'. CASE PRESENTATION In this case report, we mistakenly identified 'cerebrospinal fluid' as 'pleural effusion' and proceeded with drainage. This error posed significant risks to the patient and holds valuable implications for the future diagnosis and treatment of similar patients. CONCLUSIONS In patients with Neurofibromatosis type 1 complicated by spinal deformity, there is a high incidence of intrathoracic meningoceles. Treatment strategies may differ based on the specific features of the lesions, and collaboration among multiple disciplines can significantly improve patient outcomes.
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Affiliation(s)
- Ningyi Chen
- Department of Respiratory Medicine, Northern Jiangsu People's Hospital Affiliated to Yangzhou University, Yangzhou, 225001, People's Republic of China
| | - Wenjuan Li
- Department of Respiratory Medicine, Northern Jiangsu People's Hospital Affiliated to Yangzhou University, Yangzhou, 225001, People's Republic of China
| | - Lingfeng Min
- Department of Respiratory Medicine, Northern Jiangsu People's Hospital Affiliated to Yangzhou University, Yangzhou, 225001, People's Republic of China
| | - Qian Huang
- Department of Respiratory Medicine, Northern Jiangsu People's Hospital Affiliated to Yangzhou University, Yangzhou, 225001, People's Republic of China
| | - Jiarong Bian
- Department of Respiratory Medicine, Northern Jiangsu People's Hospital Affiliated to Yangzhou University, Yangzhou, 225001, People's Republic of China.
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2
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Yeager LB, Kassotis A, Frank T, Li CY, Marr BP. A Review of Pediatric Ophthalmic Tumors. Pediatr Rev 2024; 45:119-131. [PMID: 38425168 DOI: 10.1542/pir.2023-006163] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/02/2024]
Abstract
Tumors of the eye, orbit, and ocular adnexa can arise in the pediatric population. These entities can be both vision- and life-threatening and may be associated with systemic disease. Given their relative rarity, pediatricians must be aware of these conditions and understand what findings warrant immediate referral to an ophthalmologist for initiation of further testing. We aimed to review these conditions and highlight clinical features to promote awareness and expedite diagnosis. Tumors are subdivided into the following categories for review: anterior tumors of the eyelid and ocular surface, orbital tumors, and intraocular tumors.
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Affiliation(s)
- Lauren B Yeager
- Edward S. Harkness Eye Institute, Columbia University Irving Medical Center, New York, NY
| | - Alexis Kassotis
- Edward S. Harkness Eye Institute, Columbia University Irving Medical Center, New York, NY
| | - Tahvi Frank
- Columbia University Irving Medical Center, Vagelos College of Physicians and Surgeons, New York, NY
| | - Chloe Y Li
- Edward S. Harkness Eye Institute, Columbia University Irving Medical Center, New York, NY
| | - Brian P Marr
- Edward S. Harkness Eye Institute, Columbia University Irving Medical Center, New York, NY
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Turner MD, Sunday A. A Lesion on the "King of Kings": Neurofibromas in the Parthian Empire's Arsacid Dynasty. Cureus 2023; 15:e46248. [PMID: 37908901 PMCID: PMC10614084 DOI: 10.7759/cureus.46248] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/29/2023] [Indexed: 11/02/2023] Open
Abstract
Multiple kings of the Arsacid Dynasty of the ancient Parthian Empire are depicted on their coinage with a recurrent facial lesion, one that is found across multiple generations. Multiple theories have attempted to explain this phenomenon, from basal cell carcinoma to hereditary trichoepithelioma. In this paper, we suggest that these lesions are possibly a representation of the neurofibromas found in Neurofibromatosis 1, an autosomal dominant disease process.
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Affiliation(s)
- Matthew D Turner
- Emergency Medicine, Penn State Health Milton S. Hershey Medical Center, Hershey, USA
| | - Adam Sunday
- Emergency, Penn State Health Milton S. Hershey Medical Center, Hershey, USA
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Omura T, Ikawa K, Kudo E. Acute hemorrhagic cholecystitis related to diffuse neurofibroma of gallbladder in a patient with neurofibromatosis type 1. Surg Case Rep 2023; 9:62. [PMID: 37079137 PMCID: PMC10119345 DOI: 10.1186/s40792-023-01647-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2023] [Accepted: 04/12/2023] [Indexed: 04/21/2023] Open
Abstract
BACKGROUND We report the first case of acute hemorrhagic cholecystitis with large hemoperitoneum related to gallbladder wall fragility caused by neurofibroma cell infiltration. CASE PRESENTATION A 46-year-old man with neurofibromatosis type 1 (NF1), who had been hospitalized for retroperitoneal hematoma and treated by transarterial embolization 9 days earlier, complained of right upper quadrant pain, bloating, nausea, and emesis. Computed tomography revealed fluid collection and a distended gallbladder with high-density contents. The patient was taken to the operating room for laparoscopic cholecystectomy, with consideration of the hemodynamic tolerance, for acute hemorrhagic cholecystitis. An initial laparoscopy revealed a significant amount of blood in the abdominal cavity exuding from the gallbladder. Due to its fragility, the gallbladder was easily ruptured by surgical manipulation. After conversion to open surgery, subtotal cholecystectomy was performed. Seventeen days after surgery, the patient was transferred to another hospital for rehabilitation. Histological examination revealed diffuse and nodular proliferation of spindle cells that had replaced the muscularis propria of the gallbladder wall. CONCLUSION This clinical case highlights how NF1 can cause various symptoms in the blood vessels and gastrointestinal tract, including the gallbladder.
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Affiliation(s)
- Takeshi Omura
- Department of Surgery, Tokushima Prefectural Central Hospital, Kuramoto-cho, 1-10-3, Tokushima, 770-8539, Japan.
- Emergency Surgery and Trauma Center, Tokushima Prefectural Central Hospital, Kuramoto-cho, 1-10-3, Tokushima, 770-8539, Japan.
| | - Koichi Ikawa
- Department of Surgery, Tokushima Prefectural Central Hospital, Kuramoto-cho, 1-10-3, Tokushima, 770-8539, Japan
- Emergency Surgery and Trauma Center, Tokushima Prefectural Central Hospital, Kuramoto-cho, 1-10-3, Tokushima, 770-8539, Japan
| | - Eiji Kudo
- Department of Pathology, Tokushima Prefectural Central Hospital, Kuramoto-cho, 1-10-3, Tokushima, 770-8539, Japan
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KANNO DT, de MATTOS RLM, CAMPOS FG, SIQUEIRA RM, de CARVALHO RB, REAL MARTINEZ CA. MULTIPLE NEUROENDOCRINE NEOPLASIA IN A PATIENT WITH TYPE I NEUROFIBROMATOSIS (NF1): REPORT OF A NEW MUTATION (NF1, EXONS 2-30 DELETION) AND LITERATURE REVIEW. ARQUIVOS BRASILEIROS DE CIRURGIA DIGESTIVA : ABCD = BRAZILIAN ARCHIVES OF DIGESTIVE SURGERY 2023; 35:e1702. [PMID: 36629684 PMCID: PMC9831629 DOI: 10.1590/0102-672020220002e1702] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/23/2022] [Accepted: 10/01/2022] [Indexed: 01/11/2023]
Abstract
BACKGROUND Plexiform neurofibromas represent a common neoplasia of type 1 neurofibromatosis in which neurofibromas arise from multiple nerves involving connective tissue and skin and rarely affect the colon and rectum. Co-occurrence of plexiform neurofibromas, neuroendocrine tumors with primary involvement of the rectum, and medullary thyroid carcinoma in patients with neurofibromatosis type 1 is a previously undescribed condition. The aim of this manuscript was to present a case of primary plexiform neurofibroma and neuroendocrine tumors of the upper rectum in a patient with neurofibromatosis type 1 whose genetic sequencing found a novel mutation in the neurofibromatosis type 1 gene and to review the literature. CASE REPORT A 49-year-old woman with a familial history of neurofibromatosis type 1 complained of abdominal cramps for 6 months. She had previously been submitted for a total thyroidectomy due to medullary thyroid carcinoma. She was submitted to a colonoscopy, which identified a submucosa lesion located in the upper rectum. The patient was referred for a laparoscopic rectosigmoidectomy, and the histopathological study of the surgical specimen identified two different tumors. An immunohistochemical panel was done for histopathological confirmation of the etiology of both lesions. The results of the panel showed intense immunoexpression of S100 protein in the largest and superficial lesion, as well as positivity for chromogranin and synaptophysin in the minor and deep lesion confirming the diagnosis of rectal plexiform neurofibromas concomitant with neuroendocrine tumors. The proliferative activity rate using Ki-67 antibodies showed that both tumors had a low rate of mitotic activity (<1%). Genetic sequence panel identified an undescribed mutation in the neurofibromatosis type 1 gene (deletion, exons 2-30). The patient's postoperative evolution was uneventful, and she remains well, without recurrence, 3 years after surgery. CONCLUSION The co-occurrence of medullary thyroid carcinoma, plexiform neurofibromas, and neuroendocrine tumors of the rectum in patients with neurofibromatosis type 1 is an exceptional and undescribed possibility, whose diagnosis can be confirmed by the immunohistochemical staining and genetic panel.
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Affiliation(s)
- Danilo Toshio KANNO
- Universidade São Francisco, Graduate Program in Health Sciences – Bragança Paulista (SP), Brazil
| | | | - Fábio Guilherme CAMPOS
- Universidade São Francisco, Graduate Program in Health Sciences – Bragança Paulista (SP), Brazil
| | - Rayama Moreira SIQUEIRA
- Universidade São Francisco, Graduate Program in Health Sciences – Bragança Paulista (SP), Brazil
| | | | - Carlos Augusto REAL MARTINEZ
- Universidade São Francisco, Graduate Program in Health Sciences – Bragança Paulista (SP), Brazil;,Universidade Estadual de Campinas, Department of Surgery, Gastrocenter – Campinas (SP), Brazil
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Santos MR, Pereira AM. Neurofibromatosis type 1 and pulmonary arterial hypertension: A case report. Rev Port Cardiol 2022; 41:511.e1-511.e5. [DOI: 10.1016/j.repc.2019.05.018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2019] [Accepted: 05/11/2019] [Indexed: 10/18/2022] Open
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Hallan DR, Messner C, Daggubati LC, Sakya S, Thomas S, Rizk E. Evaluating the Evidence: Scientometric Analysis of Highly Cited Neurofibromatosis 1 Publications. Cureus 2022; 14:e23466. [PMID: 35481324 PMCID: PMC9034899 DOI: 10.7759/cureus.23466] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2021] [Accepted: 03/24/2022] [Indexed: 11/18/2022] Open
Abstract
The study of Neurofibromatosis 1 (NF1) is progressing rapidly. This study aimed to identify historical trends in publications focusing on NF1, to find the top 100 most cited publications on this topic, and to evaluate their level of evidence. This study identifies historical trends in publication regarding NF1 with the aim of providing readers useful information about the areas of research being performed, an educational guide to facilitate novice researchers in conducting effective evidence-based medical research, and unique insight into developments and trends of NF 1 research. This study also evaluates the evidence of highly cited papers on NF1. A search of all databases and journals accessible within Elsevier's Scopus was performed on June 27th, 2020, using combinations of the Boolean queries "Neurofibromatosis 1," "Von Recklinghausen," and "NF1," which yielded 13,599 documents. The top 100 most-cited papers were identified, analyzed, and evaluated for level of evidence. Evidence was assessed using the GRADE guidelines. The top 100 most-cited articles span years 1963-2010 and are published in 50 different journals. The average number of citations per publication was 366.5 (range 189-1527). The most cited article is "Neurofibromatosis: Conference Statement" (Stumpf et al., 1988). In this study, the top 100 most-cited works in NF1 are identified, characterized, and analyzed. This study will serve as a historical point of reference for future research, a jumping point for those unfamiliar with the topic, and an educational foundation for future NF1 specialists and researchers.
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8
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Khushaim A, Albaradi A, Alsalim A. Early presentation of neurofibromatosis type I patient with clitoromegaly and café au lait spots: A case report. Radiol Case Rep 2022; 17:667-669. [PMID: 35003457 PMCID: PMC8715292 DOI: 10.1016/j.radcr.2021.11.071] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2021] [Revised: 11/25/2021] [Accepted: 11/28/2021] [Indexed: 11/01/2022] Open
Abstract
Neurofibromatosis is a rare genetic disorder that typically affects the nerves and causes benign tumors. It also affects different parts of the body, including the bone, skin, and genitourinary system. We report a case of a 6-year-old girl medically free who was referred to our institute with clitoromegaly and multiple café au lait spots on the skin. Clitoral mass excision was performed, and histopathology confirmed the diagnosis of clitoral plexiform neurofibroma as a primary presentation of Neurofibromatosis type I.
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9
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Knight SWE, Knight TE, Santiago T, Murphy AJ, Abdelhafeez AH. Malignant Peripheral Nerve Sheath Tumors-A Comprehensive Review of Pathophysiology, Diagnosis, and Multidisciplinary Management. CHILDREN (BASEL, SWITZERLAND) 2022; 9:children9010038. [PMID: 35053663 PMCID: PMC8774267 DOI: 10.3390/children9010038] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/22/2021] [Revised: 12/14/2021] [Accepted: 12/22/2021] [Indexed: 02/06/2023]
Abstract
Malignant peripheral nerve sheath tumors (MPNSTs) are aggressive soft tissue sarcomas (STS) with nerve sheath differentiation and a tendency to metastasize. Although occurring at an incidence of 0.001% in the general population, they are relatively common in individuals with neurofibromatosis type 1 (NF1), for whom the lifetime risk approaches 10%. The staging of MPNSTs is complicated and requires close multi-disciplinary collaboration. Their primary management is most often surgical in nature, with non-surgical modalities playing a supportive, necessary role, particularly in metastatic, invasive, or widespread disease. We, therefore, sought to provide a comprehensive review of the relevant literature describing the characteristics of these tumors, their pathophysiology and risk factors, their diagnosis, and their multi-disciplinary treatment. A close partnership between surgical and medical oncologists is therefore necessary. Advances in the molecular characterization of these tumors have also begun to allow the integration of targeted RAS/RAF/MEK/ERK pathway inhibitors into MPNST management.
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Affiliation(s)
- Samantha W. E. Knight
- Division of Surgery, Department of General Surgery, Southern Illinois University School of Medicine, Springfield, IL 62702, USA;
| | - Tristan E. Knight
- Cancer and Blood Disorders Center, Seattle Children’s Hospital, Seattle, WA 98195, USA;
- Division of Hematology and Oncology, Department of Pediatrics, University of Washington School of Medicine, Seattle, WA 98195, USA
| | - Teresa Santiago
- Department of Pathology, St. Jude Children’s Research Hospital, Memphis, TN 38105, USA;
| | - Andrew J. Murphy
- Department of Surgery, St. Jude Children’s Research Hospital, Memphis, TN 38105, USA;
- Division of Pediatric Surgery, Department of Surgery, University of Tennessee Health Science Center, Memphis, TN 38105, USA
| | - Abdelhafeez H. Abdelhafeez
- Department of Surgery, St. Jude Children’s Research Hospital, Memphis, TN 38105, USA;
- Division of Pediatric Surgery, Department of Surgery, University of Tennessee Health Science Center, Memphis, TN 38105, USA
- Correspondence: ; Tel.: +1-(901)-595-2315; Fax: +1-(901)-595-2207
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Quinonez J, Ruxmohan S, Paesani S, Patel A, Edaki O. Glioma-Induced Seizure in a Neurofibromatosis Type 1 Patient: A Case Report. Cureus 2021; 13:e19435. [PMID: 34909339 PMCID: PMC8663752 DOI: 10.7759/cureus.19435] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/10/2021] [Indexed: 11/11/2022] Open
Abstract
Neurofibromatosis type 1 (NF-1), also known as Von Recklinghausen's disease, is an autosomal-dominant disease that is characterized by high-frequency mutations leading to multiple benign tumors called neurofibromas and café au lait spots on the skin. Although NF-1 mainly affects the nervous system, it can have multisystem involvement as well, associated with the cardiovascular, orthopedic, gastrointestinal, and dermatologic systems. Psychiatric complications like anxiety, dysthymia, and depression have also been reported in patients with NF-1. The prevalence of this disorder is one in 3,000 births. NF-1 patients have a higher prevalence of seizures compared to the general population. A 20-year-old male with a diagnosis of NF-1 at the age of three months presented to the emergency room (ER) of a local hospital for the evaluation of an unwitnessed seizure characterized by loss of consciousness and bladder control. MRI of the brain without contrast revealed hyperintensities in the mesial temporal lobe bilaterally, with a hyperintense FLAIR lesion in the splenium of the corpus callosum. The patient exhibited sudden aggression and combativeness while in the ER and also experienced a second seizure, which prompted immediate intubation. A second MRI with contrast confirmed the presence of the lesion. The patient also underwent electroencephalogram (EEG) monitoring later during his hospital stay, the results of which were unremarkable. This case report discusses an adult male with NF-1 and a tumor of the splenium of the corpus callosum. The displayed imaging suggested a possible etiology for high seizure frequency in patients with NF-1 compared to the general population.
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Affiliation(s)
- Jonathan Quinonez
- Neurology/Osteopathic Neuromuscular Medicine, Larkin Community Hospital, Miami, USA
| | | | | | - Abhinav Patel
- Radiology, Northwestern University Feinberg School of Medicine, Chicago, USA
| | - Omo Edaki
- Division of Research and Academic Affairs, Larkin Community Hospital, Miami, USA
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11
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Mu X, Zhang HY, Shen YH, Yang HY. Familial left cervical neurofibromatosis 1 with scoliosis: A case report. World J Clin Cases 2021; 9:8839-8845. [PMID: 34734064 PMCID: PMC8546810 DOI: 10.12998/wjcc.v9.i29.8839] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/30/2021] [Revised: 06/18/2021] [Accepted: 08/18/2021] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Neurofibromatosis type 1 (NF1) is an inherited autosomal dominant disorder affecting many parts of the body with café au lait spots, skeletal deformity, and scoliosis. A familial case of NF1 with scoliosis and a painless mass had not yet been reported.
CASE SUMMARY We describe the case of a 15-year-old male patient with a painless lump on the left side of his neck for 10 years and scoliosis. His right shoulder was about 5 cm lower than the left, the left side of his face was deformed, and the left submandibular skin was relaxed. The folding and drooping were obvious and movement was poor. Computed tomography revealed the involvement of the neck, upper chest wall, and surrounding left shoulder, accompanied by bone changes and scoliosis. Histological evaluation showed subepidermal pale blue mucoid degeneration, fibrous fusiform cells in the dermis in a fascicular, woven arrangement. His mother had the same medical history. The diagnosis was neurofibromatosis of the left neck. Various parts of the tumor tissue were serially resected during several visits. Eight months after surgery, there was a slight tendency to regrow.
CONCLUSION This case of slow-progressing NF1 highlights the importance of early diagnosis and treatment to reduce its impact on the patient’s growth and development.
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Affiliation(s)
- Xia Mu
- School of Stomatology, Zunyi Medical University, Zunyi 563000, Guizhou Province, China
- Department of Stomatology, Peking University Shenzhen Hospital, Shenzhen 518036, Guangdong Province, China
| | - Han-Yu Zhang
- Department of Oral and Maxillofacial Surgery, Peking University Shenzhen Hospital, Shenzhen 518036, Guangdong Province, China
| | - Yue-Hong Shen
- Department of Stomatology, Peking University Shenzhen Hospital, Shenzhen 518036, Guangdong Province, China
| | - Hong-Yu Yang
- School of Stomatology, Zunyi Medical University, Zunyi 563000, Guizhou Province, China
- Department of Stomatology, Peking University Shenzhen Hospital, Shenzhen 518036, Guangdong Province, China
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Yavuz S, Abdullah MK, Francis N. Pulmonary Arterial Hypertension as a Fatal Complication of Neurofibromatosis Type 1 in a Neonate: A Diagnostic Dilemma. Cureus 2021; 13:e17137. [PMID: 34408961 PMCID: PMC8362863 DOI: 10.7759/cureus.17137] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/12/2021] [Indexed: 11/26/2022] Open
Abstract
Neurofibromatosis type 1 (NF1), or von Recklinghausen disease, is a genetically transmitted autosomal dominant disease, with a prevalence of one per 4000 live births. Pulmonary arterial hypertension (PAH) is a rare but potentially life-threatening complication of NF1. There are no confirmatory data about the congenital association between PAH and NF1. However, in most cases, PAH is observed in late childhood or adulthood. Herein, we present a preterm baby with genetically confirmed NF1 who presented with PAH.
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Affiliation(s)
- Sinan Yavuz
- Department of Pediatrics/ Specialist Pediatric, Al Qassimi Women and Children Hospital, Sharjah, ARE
| | - Mona K Abdullah
- Department of Pediatrics /Consultant Pediatrics and Neonatology, Al Qassimi Women and Children Hospital, Sharjah, ARE
| | - Nader Francis
- Department of Pediatrics/ Consultant Pediatric Pulmonology, Al Qassimi Women and Children Hospital, Sharjah, ARE
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ÇALIŞKAN KAMIŞ Ş, YAĞCI-KÜPELİ B. Factors affecting clinical phenotype in children with neurofibromatosis type 1. CUKUROVA MEDICAL JOURNAL 2021. [DOI: 10.17826/cumj.876942] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
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14
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Issa B, Mansour E, Jabbour G, Chikhani C, Mansour H, Jabbour M. Plexiform Penile Neurofibroma: A Case Report of a Rare Entity in a Pre-Pubertal Child. Urology 2021; 156:e124-e126. [PMID: 34129894 DOI: 10.1016/j.urology.2021.06.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2021] [Revised: 05/24/2021] [Accepted: 06/01/2021] [Indexed: 11/30/2022]
Abstract
Neurofibromatosis is a group of genetic disorders and consists of 2 forms: Neurofibromatosis type 1 (NF-1) and Neurofibromatosis type 2. The most common is the NF-1 which is also known as von Recklinghausen's disease. The presentation and clinical manifestations of this condition vary greatly. It is usually characterized by café-au-lait spots and neurofibromas. In this report, the case of a 12-year-old boy with NF-1 is presented. The boy has several café-au-lait spots along with inguinal and axillary freckles. He was found to have a rare and unusual neurofibroma of the penis.
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Affiliation(s)
- Bassim Issa
- Department of Urology, Saint George hospital university hospital, Beirut, Lebanon
| | - Elias Mansour
- Department of Urology, Saint George hospital university hospital, Beirut, Lebanon
| | | | - Carla Chikhani
- Department of Pediatrics, Saint George hospital university hospital, Beirut, Lebanon
| | - Hicham Mansour
- Department of Pediatrics, Saint George hospital university hospital, Beirut, Lebanon
| | - Michel Jabbour
- Department of Urology, Saint George hospital university hospital, Beirut, Lebanon.
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15
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Ait Ali H, Zeriouh B, Egyir Ebo U, Serji B, Elharroudi T. Solitary and complicated neurofibroma of small Bowel: A case report. Int J Surg Case Rep 2021; 78:126-129. [PMID: 33340979 PMCID: PMC7750123 DOI: 10.1016/j.ijscr.2020.12.020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2020] [Revised: 12/05/2020] [Accepted: 12/05/2020] [Indexed: 11/15/2022] Open
Abstract
INTRODUCTION 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. PRESENTATION OF CASE 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. DISCUSSION 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. CONCLUSION 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.
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Affiliation(s)
- Hassane Ait Ali
- Department of Oncological Surgery, Mohamed VI University Hospital Center, Oujda, Morocco.
| | - Brahim Zeriouh
- Department of Oncological Surgery, Mohamed VI University Hospital Center, Oujda, Morocco
| | - Usman Egyir Ebo
- Department of Oncological Surgery, Mohamed VI University Hospital Center, Oujda, Morocco
| | - Badr Serji
- Department of Oncological Surgery, Mohamed VI University Hospital Center, Oujda, Morocco
| | - Tijani Elharroudi
- Department of Oncological Surgery, Mohamed VI University Hospital Center, Oujda, Morocco
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Jutant EM, Jaïs X, Girerd B, Savale L, Ghigna MR, Perros F, Mignard X, Jevnikar M, Bourlier D, Prevot G, Tromeur C, Bauer F, Bergot E, Dauphin C, Favrolt N, Traclet J, Soumagne T, De Groote P, Chabanne C, Magro P, Bertoletti L, Gueffet JP, Chaouat A, Goupil F, Moceri P, Borie R, Fadel E, Wolkenstein P, Brillet PY, Simonneau G, Sitbon O, Humbert M, Montani D. Phenotype and Outcomes of Pulmonary Hypertension Associated with Neurofibromatosis Type 1. Am J Respir Crit Care Med 2020; 202:843-852. [PMID: 32437637 DOI: 10.1164/rccm.202001-0105oc] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Rationale: Pulmonary hypertension (PH) associated with neurofibromatosis type 1 (NF1) is a rare and largely unknown complication of NF1.Objectives: To describe characteristics and outcomes of PH-NF1.Methods: We reported the clinical, functional, radiologic, histologic, and hemodynamic characteristics, response to pulmonary arterial hypertension (PAH)-approved drugs, and transplant-free survival of patients with PH-NF1 from the French PH registry.Measurements and Main Results: We identified 49 PH-NF1 cases, characterized by a female/male ratio of 3.9 and a median (minimum-maximum) age at diagnosis of 62 (18-82) years. At diagnosis, 92% were in New York Heart Association functional class III or IV. The 6-minute-walk distance was 211 (0-460) m. Pulmonary function tests showed low DlCO (30% [12-79%]) and severe hypoxemia (PaO2 56 [38-99] mm Hg). Right heart catheterization showed severe precapillary PH with a mean pulmonary artery pressure of 45 (10) mm Hg and a pulmonary vascular resistance of 10.7 (4.2) Wood units. High-resolution computed tomography images revealed cysts (76%), ground-glass opacities (73%), emphysema (49%), and reticulations (39%). Forty patients received PAH-approved drugs with a significant improvement in functional class and hemodynamic parameters. Transplant-free survival at 1, 3, and 5 years was 87%, 54%, and 42%, respectively, and four patients were transplanted. Pathologic assessment showed nonspecific interstitial pneumonia and major pulmonary vascular remodeling.Conclusions: PH-NF1 is characterized by a female predominance, a low DlCO, and severe functional and hemodynamic impairment. Despite a potential benefit of PAH treatment, prognosis remains poor, and double-lung transplantation is an option for eligible patients.
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Affiliation(s)
- Etienne-Marie Jutant
- School of Medicine, Université Paris-Saclay, Le Kremlin-Bicêtre, France.,INSERM UMR_S 999 Pulmonary Hypertension: Pathophysiology and Novel Therapies.,Department of Respiratory and Intensive Care Medicine, Pulmonary Hypertension National Referral Center, Hôpital Bicêtre, Assistance Publique-Hôpitaux de Paris (AP-HP), Le Kremlin-Bicêtre, France
| | - Xavier Jaïs
- School of Medicine, Université Paris-Saclay, Le Kremlin-Bicêtre, France.,INSERM UMR_S 999 Pulmonary Hypertension: Pathophysiology and Novel Therapies.,Department of Respiratory and Intensive Care Medicine, Pulmonary Hypertension National Referral Center, Hôpital Bicêtre, Assistance Publique-Hôpitaux de Paris (AP-HP), Le Kremlin-Bicêtre, France
| | - Barbara Girerd
- School of Medicine, Université Paris-Saclay, Le Kremlin-Bicêtre, France.,INSERM UMR_S 999 Pulmonary Hypertension: Pathophysiology and Novel Therapies.,Department of Respiratory and Intensive Care Medicine, Pulmonary Hypertension National Referral Center, Hôpital Bicêtre, Assistance Publique-Hôpitaux de Paris (AP-HP), Le Kremlin-Bicêtre, France
| | - Laurent Savale
- School of Medicine, Université Paris-Saclay, Le Kremlin-Bicêtre, France.,INSERM UMR_S 999 Pulmonary Hypertension: Pathophysiology and Novel Therapies.,Department of Respiratory and Intensive Care Medicine, Pulmonary Hypertension National Referral Center, Hôpital Bicêtre, Assistance Publique-Hôpitaux de Paris (AP-HP), Le Kremlin-Bicêtre, France
| | - Maria-Rosa Ghigna
- INSERM UMR_S 999 Pulmonary Hypertension: Pathophysiology and Novel Therapies.,Service d'Anatomopathologie, and
| | - Frédéric Perros
- School of Medicine, Université Paris-Saclay, Le Kremlin-Bicêtre, France.,INSERM UMR_S 999 Pulmonary Hypertension: Pathophysiology and Novel Therapies.,Department of Respiratory and Intensive Care Medicine, Pulmonary Hypertension National Referral Center, Hôpital Bicêtre, Assistance Publique-Hôpitaux de Paris (AP-HP), Le Kremlin-Bicêtre, France
| | - Xavier Mignard
- School of Medicine, Université Paris-Saclay, Le Kremlin-Bicêtre, France.,INSERM UMR_S 999 Pulmonary Hypertension: Pathophysiology and Novel Therapies.,Department of Respiratory and Intensive Care Medicine, Pulmonary Hypertension National Referral Center, Hôpital Bicêtre, Assistance Publique-Hôpitaux de Paris (AP-HP), Le Kremlin-Bicêtre, France
| | - Mitja Jevnikar
- School of Medicine, Université Paris-Saclay, Le Kremlin-Bicêtre, France.,INSERM UMR_S 999 Pulmonary Hypertension: Pathophysiology and Novel Therapies.,Department of Respiratory and Intensive Care Medicine, Pulmonary Hypertension National Referral Center, Hôpital Bicêtre, Assistance Publique-Hôpitaux de Paris (AP-HP), Le Kremlin-Bicêtre, France
| | - Delphine Bourlier
- Service des Maladies Respiratoires, Hôpital Haut-Lévêque CHU Bordeaux Pessac, France
| | - Grégoire Prevot
- Pneumologie et Maladies Rares, Pôle Voies Respiratoires, Hôpital Larrey, Toulouse, France
| | - Cécile Tromeur
- Service de Pneumologie, Hôpital de la Cavale Blanche, Brest, France
| | - Fabrice Bauer
- INSERM U1096, Heart Failure Clinic and Pulmonary Hypertension Center, Rouen, France.,Service de Chirurgie Cardiaque, Hôpital Charles Nicole, Rouen, France
| | - Emmanuel Bergot
- Service de Pneumologie et Oncologie Thoracique, CHU Côte de Nacre, Caen, France
| | - Claire Dauphin
- Service de Cardiologie et Maladies Vasculaires, Hôpital Gabriel Montpied, Clermont Ferrand, France
| | - Nicolas Favrolt
- Service de Pneumologie et Soins Intensifs Respiratoires, CHU François Mitterrand, Dijon, France
| | - Julie Traclet
- Service de Pneumologie, Hôpital Louis Pradel, Lyon, France
| | | | - Pascal De Groote
- Service de Cardiologie, CHU Lille, Lille, France.,INSERM U1167, Institut Pasteur de Lille, Lille, France
| | - Céline Chabanne
- Service de Chirurgie Thoracique, Cardiaque et Vasculaire, Hôpital Pontchaillou, Rennes, France
| | - Pascal Magro
- Service de Pneumologie, CHU de Tours, Tours, France
| | - Laurent Bertoletti
- Service de Médecine Vasculaire et Thérapeutique, CHU de St-Etienne, St-Etienne, France.,INSERM, UMR1059, Université Jean-Monnet, St-Etienne, France.,INSERM, CIC-1408, CHU Saint-Etienne, Saint-Etienne, France
| | - Jean-Pierre Gueffet
- Unité de Soins et de Cardiologie Interventionnelle, Hôpital Privé du Confluent, Nantes, France
| | - Ari Chaouat
- Centre Hospitalier Régional Universitaire de Nancy, Département de Pneumologie, Hôpital de Brabois, Vandoeuvre-lès-Nancy, France.,INSERM UMR_S 1116, Défaillance Cardiovasculaire Aigüe et Chronique, Faculté de Médecine de Nancy, Université de Lorraine, Nancy, France
| | | | | | - Raphael Borie
- Service de Pneumologie, Hôpital Bichat, AP-HP, Paris, France
| | - Elie Fadel
- INSERM UMR_S 999 Pulmonary Hypertension: Pathophysiology and Novel Therapies.,Pôle de Chirurgie Cardiaque Congénitale et Pédiatrique, Hôpital Marie Lannelongue, Le Plessis-Robinson, France
| | - Pierre Wolkenstein
- Service de Dermatologie, CHU Mondor, AP-HP, Créteil, France.,Université Paris-Est Créteil, Créteil, France
| | - Pierre-Yves Brillet
- Service de Radiologie, Hôpital Avicenne, AP-HP, Bobigny, France; and.,Unité INSERM 1272, Université Paris 13, Villetaneuse, France
| | - Gérald Simonneau
- School of Medicine, Université Paris-Saclay, Le Kremlin-Bicêtre, France.,INSERM UMR_S 999 Pulmonary Hypertension: Pathophysiology and Novel Therapies.,Department of Respiratory and Intensive Care Medicine, Pulmonary Hypertension National Referral Center, Hôpital Bicêtre, Assistance Publique-Hôpitaux de Paris (AP-HP), Le Kremlin-Bicêtre, France
| | - Olivier Sitbon
- School of Medicine, Université Paris-Saclay, Le Kremlin-Bicêtre, France.,INSERM UMR_S 999 Pulmonary Hypertension: Pathophysiology and Novel Therapies.,Department of Respiratory and Intensive Care Medicine, Pulmonary Hypertension National Referral Center, Hôpital Bicêtre, Assistance Publique-Hôpitaux de Paris (AP-HP), Le Kremlin-Bicêtre, France
| | - Marc Humbert
- School of Medicine, Université Paris-Saclay, Le Kremlin-Bicêtre, France.,INSERM UMR_S 999 Pulmonary Hypertension: Pathophysiology and Novel Therapies.,Department of Respiratory and Intensive Care Medicine, Pulmonary Hypertension National Referral Center, Hôpital Bicêtre, Assistance Publique-Hôpitaux de Paris (AP-HP), Le Kremlin-Bicêtre, France
| | - David Montani
- School of Medicine, Université Paris-Saclay, Le Kremlin-Bicêtre, France.,INSERM UMR_S 999 Pulmonary Hypertension: Pathophysiology and Novel Therapies.,Department of Respiratory and Intensive Care Medicine, Pulmonary Hypertension National Referral Center, Hôpital Bicêtre, Assistance Publique-Hôpitaux de Paris (AP-HP), Le Kremlin-Bicêtre, France
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17
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Rago A, Tordi A, Siniscalchi A, Andrizzi C, Campagna S, Toritto TCD. Identifying the link between multiple myeloma and neurofibromatosis type I. Blood Res 2020; 55:187-189. [PMID: 32989179 PMCID: PMC7536567 DOI: 10.5045/br.2020.2020102] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2020] [Revised: 08/30/2020] [Accepted: 08/31/2020] [Indexed: 11/17/2022] Open
Affiliation(s)
- Angela Rago
- Haematology Unit, ASL Roma 1, Santo Spirito Hospital of Rome, Italy
| | - Attilio Tordi
- Haematology Unit, ASL Roma 1, Santo Spirito Hospital of Rome, Italy
| | | | | | - Selenia Campagna
- Haematology Unit, ASL Roma 1, Santo Spirito Hospital of Rome, Italy
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18
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Meazza C, Schiavello E, Biassoni V, Podda M, Barteselli C, Barretta F, Gattuso G, Terenziani M, Ferrari A, Spreafico F, Luksch R, Casanova M, Chiaravalli S, Puma N, Bergamaschi L, Massimino M. Cancer treatment in disabled children. Eur J Pediatr 2020; 179:1353-1360. [PMID: 32140854 DOI: 10.1007/s00431-020-03607-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/16/2020] [Revised: 02/03/2020] [Accepted: 02/05/2020] [Indexed: 01/01/2023]
Abstract
The incidence of cancer in children with intellectual disability has been poorly documented. We report our experience of treating children and adolescents with cancer and intellectual disability (40 patients), from 2004 to 2018. A treatment-sparing approach was adopted for 6 patients with severe intellectual impairment to minimize toxicity: a child with postpartum asphyxia and medulloblastoma did not receive radiotherapy; 1 patient with mitochondrial encephalopathy and a testicular germ cell tumor did not receive bleomycin and lung metastasectomy; 2 patients (1 with Down + West syndrome + Wilms tumor (WT) and 1 with Denys-Drash syndrome + WT) did not receive vincristine; 1 child with corpus callosum agenesis and anaplastic ependymoma did not receive chemotherapy; 1 child with structural chromosomal aberrations and a primitive neuro-ectodermal tumor received personalized chemotherapy. Heminephrectomy was performed in 4 patients with WT to preserve their kidney function. We found no statistically significant correlation between relapse or mortality rates and the use of a treatment-sparing approach. The 5-year overall survival (OS) and event-free survival (EFS) rates were 84.5% and 66.1% as opposed to 82.5% and 46.9%, respectively, for patients in our usual-treatment and treatment-sparing groups.Conclusion: We only opted for a treatment-sparing approach for patients with severe disabilities, and their OS was in line with that of children without intellectual disability. What is Known: • There are few reports on children/adolescents with cancer and intellectual disability (ID). • It is not clear how to manage them and whether a treatment sparing should be considered, especially in the case of severe disability. What is New: • Most patients received the standard cancer treatment and only in the case of severe disability, a therapeutic saving approach was applied. • No statistically significant correlations between relapse/mortality rates and the use of a treatment-sparing approach were found.
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Affiliation(s)
- Cristina Meazza
- Pediatric Oncology Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Via G. Venezian, 1, 20133, Milan, MI, Italy.
| | - Elisabetta Schiavello
- Pediatric Oncology Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Via G. Venezian, 1, 20133, Milan, MI, Italy
| | - Veronica Biassoni
- Pediatric Oncology Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Via G. Venezian, 1, 20133, Milan, MI, Italy
| | - Marta Podda
- Pediatric Oncology Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Via G. Venezian, 1, 20133, Milan, MI, Italy
| | - Chiara Barteselli
- General Medicine I, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - Francesco Barretta
- Clinical Epidemiology and Trial Organization, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - Giovanna Gattuso
- Pediatric Oncology Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Via G. Venezian, 1, 20133, Milan, MI, Italy
| | - Monica Terenziani
- Pediatric Oncology Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Via G. Venezian, 1, 20133, Milan, MI, Italy
| | - Andrea Ferrari
- Pediatric Oncology Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Via G. Venezian, 1, 20133, Milan, MI, Italy
| | - Filippo Spreafico
- Pediatric Oncology Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Via G. Venezian, 1, 20133, Milan, MI, Italy
| | - Roberto Luksch
- Pediatric Oncology Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Via G. Venezian, 1, 20133, Milan, MI, Italy
| | - Michela Casanova
- Pediatric Oncology Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Via G. Venezian, 1, 20133, Milan, MI, Italy
| | - Stefano Chiaravalli
- Pediatric Oncology Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Via G. Venezian, 1, 20133, Milan, MI, Italy
| | - Nadia Puma
- Pediatric Oncology Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Via G. Venezian, 1, 20133, Milan, MI, Italy
| | - Luca Bergamaschi
- Pediatric Oncology Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Via G. Venezian, 1, 20133, Milan, MI, Italy
| | - Maura Massimino
- Pediatric Oncology Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Via G. Venezian, 1, 20133, Milan, MI, Italy
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19
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Aquilina G, Caltabiano DC, Galioto F, Cancemi G, Pino F, Vancheri A, Vancheri C, Foti PV, Mauro LA, Basile A. Cystic Interstitial Lung Diseases: A Pictorial Review and a Practical Guide for the Radiologist. Diagnostics (Basel) 2020; 10:diagnostics10060346. [PMID: 32471113 PMCID: PMC7345690 DOI: 10.3390/diagnostics10060346] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2020] [Revised: 05/19/2020] [Accepted: 05/25/2020] [Indexed: 01/30/2023] Open
Abstract
A cyst is a round circumscribed area of low attenuation, surrounded by epithelial or fibrous wall. Cysts can frequently occur on chest computed tomography (CT) and high-resolution computed tomography (HRCT); multiple parenchymal cysts of the lungs are the most typical feature of cystic lung interstitial diseases, characterizing a wide spectrum of diseases—ranging from isolated lung disorders up to diffuse pulmonary diseases. The aim of this review is to analyze scientific literature about cystic lung interstitial diseases and to provide a practical guide for radiologists, focusing on the main morphological features of pulmonary cysts: size, shape, borders, wall, location, and distribution. These features are shown on free-hand drawings and related to HRCT images, in order to help radiologists pursue the correct differential diagnosis between similar conditions.
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Affiliation(s)
- Giulia Aquilina
- Department of Medical Surgical Sciences and Advanced Technologies “GF Ingrassia”—Radiology Unit I. University hospital “Policlinico-Vittorio Emanuele” Via Santa Sofia 78, 95123 Catania, Italy; (F.G.); (G.C.); (P.V.F.); (A.B.)
- Correspondence: (G.A.); (L.A.M.); Tel.: +39-34-2700-2249 (G.A.)
| | | | - Federica Galioto
- Department of Medical Surgical Sciences and Advanced Technologies “GF Ingrassia”—Radiology Unit I. University hospital “Policlinico-Vittorio Emanuele” Via Santa Sofia 78, 95123 Catania, Italy; (F.G.); (G.C.); (P.V.F.); (A.B.)
| | - Giovanna Cancemi
- Department of Medical Surgical Sciences and Advanced Technologies “GF Ingrassia”—Radiology Unit I. University hospital “Policlinico-Vittorio Emanuele” Via Santa Sofia 78, 95123 Catania, Italy; (F.G.); (G.C.); (P.V.F.); (A.B.)
| | - Fabio Pino
- Department of Clinical and Experimental Medicine, University of Catania, Regional Referral Centre for Rare Lung Disease, 95123 Catania, Italy; (F.P.); (A.V.); (C.V.)
| | - Ada Vancheri
- Department of Clinical and Experimental Medicine, University of Catania, Regional Referral Centre for Rare Lung Disease, 95123 Catania, Italy; (F.P.); (A.V.); (C.V.)
| | - Carlo Vancheri
- Department of Clinical and Experimental Medicine, University of Catania, Regional Referral Centre for Rare Lung Disease, 95123 Catania, Italy; (F.P.); (A.V.); (C.V.)
| | - Pietro Valerio Foti
- Department of Medical Surgical Sciences and Advanced Technologies “GF Ingrassia”—Radiology Unit I. University hospital “Policlinico-Vittorio Emanuele” Via Santa Sofia 78, 95123 Catania, Italy; (F.G.); (G.C.); (P.V.F.); (A.B.)
| | - Letizia Antonella Mauro
- Department of Medical Surgical Sciences and Advanced Technologies “GF Ingrassia”—Radiology Unit I. University hospital “Policlinico-Vittorio Emanuele” Via Santa Sofia 78, 95123 Catania, Italy; (F.G.); (G.C.); (P.V.F.); (A.B.)
- Correspondence: (G.A.); (L.A.M.); Tel.: +39-34-2700-2249 (G.A.)
| | - Antonio Basile
- Department of Medical Surgical Sciences and Advanced Technologies “GF Ingrassia”—Radiology Unit I. University hospital “Policlinico-Vittorio Emanuele” Via Santa Sofia 78, 95123 Catania, Italy; (F.G.); (G.C.); (P.V.F.); (A.B.)
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20
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Ferrer G, Saleh AO, Tazelaar HD, Arrossi AV. Desquamative interstitial pneumonia in a non-smoker with neurofibromatosis type 1 (Von Recklinghausen syndrome). BMJ Case Rep 2020; 13:13/1/e227379. [PMID: 31924705 PMCID: PMC6954786 DOI: 10.1136/bcr-2018-227379] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/03/2022] Open
Abstract
Neurofibromatosis type 1 (NF1) is an autosomal dominant disorder with multiple systemic manifestations. Pulmonary involvement has been reported in the form of interstitial fibrosis, emphysema, pulmonary hypertension and thoracic neoplasm. We report a case of desquamative interstitial pneumonia in a non-smoker with NF1.
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Affiliation(s)
- Gustavo Ferrer
- Pulmonary and Critical Care Medicine, Aventura Hospital and Medical Center, Aventura, Florida, USA
| | - Alwiya Omar Saleh
- Pulmonary and Critical Care Medicine, Aventura Hospital and Medical Center, Aventura, Florida, USA
| | - Henry D Tazelaar
- Department of Laboratory Medicine/Pathology, Division of Anatomic Pathology, Mayo Clin Arizona, Scottsdale, Arizona, USA
| | - Andrea V Arrossi
- Anatomic Pathology, Cleveland Clinic Foundation, Cleveland, Ohio, USA
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21
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Raborn J, McCafferty BJ, Gunn AJ, Moawad S, Mahmoud K, Aal AKA, Saddekni S. Endovascular Management of Neurofibromatosis Type I-Associated Vasculopathy: A Case Series and Brief Review of the Literature. Vasc Endovascular Surg 2019; 54:182-190. [DOI: 10.1177/1538574419885257] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Purpose: Neurofibromatosis type 1 (NF1) is an autosomal-dominant disorder found in approximately 1 of every 3000 individuals. Neurofibromatosis type 1 can have vascular manifestations including aneurysms, stenoses, and arteriovenous malformations. The purpose of this article is to describe the clinical manifestations of NF1 vasculopathy, discuss therapeutic options, and highlight endovascular therapies from our institutional experience. Materials and Methods: The radiology information system was searched for cases of NF1. Cases with vasculopathy managed with endovascular therapies were included. Demographics, clinical histories, procedural details, and outcomes were recorded. A review of the literature for the management strategies of NF1 vasculopathy was performed. Results: Two pediatric patients with NF1 were identified, both of whom presented with hypertension found to be secondary to renal artery stenosis. One of the patients also had infrarenal aortic narrowing. Both patients were successfully treated with balloon angioplasty, resulting in improved blood pressures. The review of the literature identified case series of pharmacologic, surgical, and endovascular therapies, although, endovascular therapies appear to be preferred due to lower morbidity and mortality. Conclusions: NF1 vasculopathy is a rare condition that most often presents with hypertension due to renal artery stenosis. In these situations, endovascular management is the preferred approach.
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Affiliation(s)
- Joel Raborn
- Department of Radiology, University of Alabama at Birmingham School of Medicine, AL, USA
| | | | - Andrew J. Gunn
- Division of Vascular and Interventional Radiology, Department of Radiology, University of Alabama at Birmingham School of Medicine, AL, USA
| | - Sherif Moawad
- Department of Radiology, University of Alabama at Birmingham School of Medicine, AL, USA
| | - Khalid Mahmoud
- Division of Vascular and Interventional Radiology, Department of Radiology, University of Alabama at Birmingham School of Medicine, AL, USA
| | - Ahmed K. Abdel Aal
- Division of Vascular and Interventional Radiology, Department of Radiology, University of Alabama at Birmingham School of Medicine, AL, USA
| | - Souheil Saddekni
- Division of Vascular and Interventional Radiology, Department of Radiology, University of Alabama at Birmingham School of Medicine, AL, USA
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22
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Gandhi V, Gautam P, Chharchhodawala T, Pai N. Recurrent gastrointestinal bleeding in a patient with type 1 neurofibromatosis. BMJ Case Rep 2019; 12:12/6/e226303. [PMID: 31164378 DOI: 10.1136/bcr-2018-226303] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Type 1 neurofibromatosis (NF1) is a hereditary disorder with an incidence of approximately 1:3000 at birth. Gastrointestinal (GI) lesions occur in approximately one-third of the patients, with most being asymptomatic and diagnosed incidentally. Symptomatic lesions leading to GI bleeding are uncommon. We share our experience of an elderly man with NF1, who presented with massive recurrent GI bleeding secondary to jejunal neurofibromas. The lesions were identified on CT scan of abdomen, and the patient was managed with resection of the involved bowel segment.
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Affiliation(s)
| | - Pratik Gautam
- Gastrointestinal and HPB Surgery, Ruby Hall Clinic, Pune, Maharashtra, India
| | | | - Nitin Pai
- Medical Gastroenterology, Ruby Hall Clinic, Pune, Maharashtra, India
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23
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Rojas M, Mubarik A, Henderson EA, Agha F, Chauhan L, Iqbal AM, Vaziri A, Muddassir S. Pulmonary arterial hypertension: A rare yet fatal complication of Neurofibromatosis Type 1. Respir Med Case Rep 2019; 27:100832. [PMID: 30997327 PMCID: PMC6451192 DOI: 10.1016/j.rmcr.2019.100832] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2019] [Revised: 03/27/2019] [Accepted: 03/27/2019] [Indexed: 12/22/2022] Open
Affiliation(s)
| | - Ateeq Mubarik
- Corresponding author. Chief Resident Internal Medicine Oakhill Hospital, 11375 Cortez Blvd, Brooksville, FL, 34613, USA.
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24
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Knight T, Shatara M, Carvalho L, Altinok D, Poulik J, Wang ZJ. Dramatic response to trametinib in a male child with neurofibromatosis type 1 and refractory astrocytoma. Pediatr Blood Cancer 2019; 66:e27474. [PMID: 30251337 DOI: 10.1002/pbc.27474] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/08/2018] [Revised: 09/04/2018] [Accepted: 09/05/2018] [Indexed: 11/10/2022]
Affiliation(s)
- Tristan Knight
- Division of Pediatric Hematology and Oncology, Department of Pediatrics, Children's Hospital of Michigan, Detroit, Michigan.,Wayne State University School of Medicine, Detroit, Michigan
| | - Margaret Shatara
- Division of Pediatric Hematology and Oncology, Department of Pediatrics, Children's Hospital of Michigan, Detroit, Michigan.,Wayne State University School of Medicine, Detroit, Michigan
| | - Lindsey Carvalho
- John A. Burns School of Medicine, University of Hawaii, Honolulu, Hawaii
| | - Deniz Altinok
- Wayne State University School of Medicine, Detroit, Michigan.,Department of Radiology, Children's Hospital of Michigan, Detroit, Michigan
| | - Janet Poulik
- Wayne State University School of Medicine, Detroit, Michigan.,Department of Pathology, Children's Hospital of Michigan, Detroit, Michigan
| | - Zhihong Joanne Wang
- Division of Pediatric Hematology and Oncology, Department of Pediatrics, Children's Hospital of Michigan, Detroit, Michigan
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25
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Neoplasms of the Neuroendocrine Pancreas: An Update in the Classification, Definition, and Molecular Genetic Advances. Adv Anat Pathol 2019; 26:13-30. [PMID: 29912000 DOI: 10.1097/pap.0000000000000201] [Citation(s) in RCA: 59] [Impact Index Per Article: 11.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
This review focuses on discussing the main modifications of the recently published 2017 WHO Classification of Neoplasms of the Neuroendocrine Pancreas (panNEN). Recent updates separate pancreatic neuroendocrine tumors into 2 broad categories: well-differentiated pancreatic neuroendocrine tumors (panNET) and poorly differentiated pancreatic neuroendocrine carcinoma (panNEC), and incorporates a new subcategory of "well-differentiated high-grade NET (G3)" to the well-differentiated NET category. This new classification algorithm aims to improve the prediction of clinical outcomes and survival and help clinicians select better therapeutic strategies for patient care and management. In addition, these neuroendocrine neoplasms are capable of producing large quantity of hormones leading to clinical hormone hypersecretion syndromes. These functioning tumors include, insulinomas, glucagonomas, somatostatinomas, gastrinomas, VIPomas, serotonin-producing tumors, and ACTH-producing tumors. Although most panNENs arise as sporadic diseases, a subset of these heterogeneous tumors present as parts on inherited genetic syndromes, such as multiple endocrine neoplasia type 1, von Hippel-Lindau, neurofibromatosis type 1, tuberous sclerosis, and glucagon cell hyperplasia and neoplasia syndromes. Characteristic clinical and morphologic findings for certain functioning and syndromic panNENs should alert both pathologists and clinicians as appropriate patient management and possible genetic counseling may be necessary.
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Jutant EM, Girerd B, Jaïs X, Savale L, O'Connell C, Perros F, Sitbon O, Humbert M, Montani D. Pulmonary hypertension associated with neurofibromatosis type 1. Eur Respir Rev 2018; 27:27/149/180053. [PMID: 30158278 PMCID: PMC9488681 DOI: 10.1183/16000617.0053-2018] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2018] [Accepted: 07/28/2018] [Indexed: 12/11/2022] Open
Abstract
Neurofibromatosis type 1 (NF1), also known as von Recklinghausen disease, is a frequent autosomal dominant genetic disorder with a prevalence of 1 in 3000. Pulmonary hypertension (PH) associated with NF1 (PH-NF1) is a rare but severe complication of NF1 and is classified as Group 5 PH, defined as “PH with unclear and/or multifactorial mechanisms”. A literature review in PubMed on the association between NF1 and PH identified 18 articles describing 31 cases. PH-NF1 was characterised by a female predominance, an advanced age at diagnosis, an association with parenchymal lung disease in two out of three cases and poor long-term prognosis. NF1 is generally associated with interstitial lung disease but some cases of severe PH without parenchymal lung disease suggest that there could be a specific pulmonary vascular disease. There is no data available on the efficacy of specific pulmonary arterial hypertension treatment in PH-NF1. Therefore, these patients should be evaluated in expert PH centres and referred for lung transplantation at an early stage. As these patients have an increased risk of malignancy, careful assessment of the post-transplant malignancy risk prior to listing for transplantation is necessary. Clinical trials are needed to evaluate promising treatments targeting the RAS-downstream signalling pathways. Pulmonary hypertension is a rare but severe complication of neurofibromatosis type 1. There are no data about the efficacy of specific PAH treatment in this disease and lung transplantation should be discussed at an early stage.http://ow.ly/JMU030lezfY
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Affiliation(s)
- Etienne-Marie Jutant
- Université Paris-Sud, Faculté de Médecine, Paris, France.,AP-HP, Centre de Référence de l'Hypertension Pulmonaire Sévère, Dépt Hospitalo-Universitaire (DHU) Thorax Innovation (TORINO), Service de Pneumologie, Hôpital de Bicêtre, Paris, France.,UMR_S 999, Univ. Paris-Sud, INSERM, Laboratoire d'Excellence (LabEx) en Recherche sur le Médicament et l'Innovation Thérapeutique (LERMIT), Hôpital Marie-Lannelongue, Paris, France
| | - Barbara Girerd
- Université Paris-Sud, Faculté de Médecine, Paris, France.,AP-HP, Centre de Référence de l'Hypertension Pulmonaire Sévère, Dépt Hospitalo-Universitaire (DHU) Thorax Innovation (TORINO), Service de Pneumologie, Hôpital de Bicêtre, Paris, France.,UMR_S 999, Univ. Paris-Sud, INSERM, Laboratoire d'Excellence (LabEx) en Recherche sur le Médicament et l'Innovation Thérapeutique (LERMIT), Hôpital Marie-Lannelongue, Paris, France
| | - Xavier Jaïs
- Université Paris-Sud, Faculté de Médecine, Paris, France.,AP-HP, Centre de Référence de l'Hypertension Pulmonaire Sévère, Dépt Hospitalo-Universitaire (DHU) Thorax Innovation (TORINO), Service de Pneumologie, Hôpital de Bicêtre, Paris, France.,UMR_S 999, Univ. Paris-Sud, INSERM, Laboratoire d'Excellence (LabEx) en Recherche sur le Médicament et l'Innovation Thérapeutique (LERMIT), Hôpital Marie-Lannelongue, Paris, France
| | - Laurent Savale
- Université Paris-Sud, Faculté de Médecine, Paris, France.,AP-HP, Centre de Référence de l'Hypertension Pulmonaire Sévère, Dépt Hospitalo-Universitaire (DHU) Thorax Innovation (TORINO), Service de Pneumologie, Hôpital de Bicêtre, Paris, France.,UMR_S 999, Univ. Paris-Sud, INSERM, Laboratoire d'Excellence (LabEx) en Recherche sur le Médicament et l'Innovation Thérapeutique (LERMIT), Hôpital Marie-Lannelongue, Paris, France
| | - Caroline O'Connell
- Service de Chirurgie Thoracique, Vasculaire et Transplantation Pulmonaire, Hôpital Marie-Lannelongue, Paris, France
| | - Frederic Perros
- Université Paris-Sud, Faculté de Médecine, Paris, France.,UMR_S 999, Univ. Paris-Sud, INSERM, Laboratoire d'Excellence (LabEx) en Recherche sur le Médicament et l'Innovation Thérapeutique (LERMIT), Hôpital Marie-Lannelongue, Paris, France
| | - Olivier Sitbon
- Université Paris-Sud, Faculté de Médecine, Paris, France.,AP-HP, Centre de Référence de l'Hypertension Pulmonaire Sévère, Dépt Hospitalo-Universitaire (DHU) Thorax Innovation (TORINO), Service de Pneumologie, Hôpital de Bicêtre, Paris, France.,UMR_S 999, Univ. Paris-Sud, INSERM, Laboratoire d'Excellence (LabEx) en Recherche sur le Médicament et l'Innovation Thérapeutique (LERMIT), Hôpital Marie-Lannelongue, Paris, France
| | - Marc Humbert
- Université Paris-Sud, Faculté de Médecine, Paris, France.,AP-HP, Centre de Référence de l'Hypertension Pulmonaire Sévère, Dépt Hospitalo-Universitaire (DHU) Thorax Innovation (TORINO), Service de Pneumologie, Hôpital de Bicêtre, Paris, France.,UMR_S 999, Univ. Paris-Sud, INSERM, Laboratoire d'Excellence (LabEx) en Recherche sur le Médicament et l'Innovation Thérapeutique (LERMIT), Hôpital Marie-Lannelongue, Paris, France
| | - David Montani
- Université Paris-Sud, Faculté de Médecine, Paris, France.,AP-HP, Centre de Référence de l'Hypertension Pulmonaire Sévère, Dépt Hospitalo-Universitaire (DHU) Thorax Innovation (TORINO), Service de Pneumologie, Hôpital de Bicêtre, Paris, France.,UMR_S 999, Univ. Paris-Sud, INSERM, Laboratoire d'Excellence (LabEx) en Recherche sur le Médicament et l'Innovation Thérapeutique (LERMIT), Hôpital Marie-Lannelongue, Paris, France
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Crihalmeanu T, Ayyaswami V, Prabhu AV. Friedrich Daniel von Recklinghausen. JAMA Dermatol 2018; 154:921. [PMID: 30090944 DOI: 10.1001/jamadermatol.2018.0948] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Affiliation(s)
| | | | - Arpan V Prabhu
- University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania
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Huang L, Wu X, Ding Y, Qi L, Li W, Huang G, Dai M, Zhang B. Recurrent multiple neurofibromatosis type 1 of the right lower limb. DER ORTHOPADE 2018. [PMID: 29520415 DOI: 10.1007/s00132-017-3518-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Neurofibromatosis type 1 is an autosomal dominant inherited disease, which is characterized by the presence of multiple neurofibromas. We encountered a case in which a sporadic dispersed neurofibroma recurred locally on numerous occasions extending over 16 years. The patient developed multiple masses with a focus of neurofibroma on the right lower limb, which were excised. The patient was initially diagnosed with inflammatory changes via computed tomography and magnetic resonance imaging; however, subsequently, pathological and immunohistochemical examinations revealed an intraneural neurofibroma. The patient underwent a comprehensive and complete local resection several times. After a continuous postoperative follow-up strategy, the patient recovered well. This report describes a case of primary manifestations of multiple and recurrent neurofibromas. We aim to emphasize the possibility of a unique, recurrent, non-healing neurofibroma and review the diagnostic techniques utilized to reach a definitive diagnosis. Early and complete surgical resection is an effective method to treat and prevent this type of neurofibroma.
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Affiliation(s)
- Leitao Huang
- Department of Orthopedics, Artificial Joints Engineering and Technology Research Center of Jiangxi Province, The First Affiliated Hospital of Nanchang University, Nanchang University, 330006, Nanchang, Jiangxi, China
| | - Xia Wu
- Department of College of pharmacy, Nanchang University, 330006, Nanchang, Jiangxi, China
| | - Yi Ding
- Department of Orthopedics, Artificial Joints Engineering and Technology Research Center of Jiangxi Province, The First Affiliated Hospital of Nanchang University, Nanchang University, 330006, Nanchang, Jiangxi, China
| | - Lai Qi
- Department of Orthopedics, Artificial Joints Engineering and Technology Research Center of Jiangxi Province, The First Affiliated Hospital of Nanchang University, Nanchang University, 330006, Nanchang, Jiangxi, China
| | - Wei Li
- Department of Orthopedics, Artificial Joints Engineering and Technology Research Center of Jiangxi Province, The First Affiliated Hospital of Nanchang University, Nanchang University, 330006, Nanchang, Jiangxi, China
| | - Gendong Huang
- Department of Orthopedics, Artificial Joints Engineering and Technology Research Center of Jiangxi Province, The First Affiliated Hospital of Nanchang University, Nanchang University, 330006, Nanchang, Jiangxi, China
| | - Min Dai
- Department of Orthopedics, Artificial Joints Engineering and Technology Research Center of Jiangxi Province, The First Affiliated Hospital of Nanchang University, Nanchang University, 330006, Nanchang, Jiangxi, China.
| | - Bin Zhang
- Department of Orthopedics, Artificial Joints Engineering and Technology Research Center of Jiangxi Province, The First Affiliated Hospital of Nanchang University, Nanchang University, 330006, Nanchang, Jiangxi, China.
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Lee YM, Yang TH, Jung H, Oh TS, Song JH, Yu SJ. Pulmonary Hypertension in Patient with Neurofibromatosis Type 1. KOSIN MEDICAL JOURNAL 2017. [DOI: 10.7180/kmj.2017.32.2.227] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
Abstract
Neurofibromatosis type 1 (NF1) is a rare genetic disease. Precapillary pulmonary hypertension (PH) with NF1 is an extremely severe complication. A 65-year-old woman was admitted in our hospital with 3-year history of gradually worsening dyspnea on exertion (New York Heart Association functional class III-IV). Considering her clinical feature and examination findings, she could be diagnosed as PH associated with NF1. She was treated with endothelin receptor antagonist. However her dyspnea was not significantly improved. This is the first Korean case of NF1 patient with PH which confirmed with right heart catheterization.
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Huang L, Ding Y, Qi L, Wu X, Li W, Huang G, Dai M, Zhang B. Repeated Multiple Neurofibromatosis Type 1 in the Right Lower Limb: A Case Report. World J Oncol 2017; 8:58-61. [PMID: 29147436 PMCID: PMC5649998 DOI: 10.14740/wjon1011w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/18/2017] [Indexed: 11/26/2022] Open
Abstract
Neurofibromatosis type 1 (NF1) is an autosomal-dominant genetic disease characterized by the presence of multiple neurofibromas. We encountered a unique case of NF1 that manifested as a recurrent soft tissue neurofibroma in the right lower limb that developed over a period of 16 years. The patient presented with a painless mass that was initially diagnosed as inflammatory changes via computed tomography and magnetic resonance imaging. However, the condition was subsequently diagnosed as an intraneural neurofibroma via pathological and immunohistochemical examination, which showed a focal to patchy lymphocytic chronic inflammatory infiltrate and several non-encapsulated masses with clear boundaries that were easily distinguishable from the adjacent neurofibroma. The mass relapsed three times over 3 years since it was discovered, for which the patient underwent comprehensive and complete local resection several times. Postoperative continuous follow-up confirmed that the patient recovered well. Early and complete surgical resection is an effective method for treating and preventing recurrent neurofibromas. However, because of the importance of pathologic examination in the diagnosis of such cases, this uncommon entity might be underreported in patients with NF1.
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Affiliation(s)
- Leitao Huang
- Department of Orthopedics, Artificial Joints Engineering and Technology, Research Center of Jiangxi Province, Nanchang, China.,Department of Orthopedics, The First Affiliated Hospital of Nanchang University, Nanchang, China.,These authors contributed equally to this work
| | - Yi Ding
- Department of Orthopedics, Artificial Joints Engineering and Technology, Research Center of Jiangxi Province, Nanchang, China.,Department of Orthopedics, The First Affiliated Hospital of Nanchang University, Nanchang, China.,These authors contributed equally to this work
| | - Lai Qi
- Department of Orthopedics, Artificial Joints Engineering and Technology, Research Center of Jiangxi Province, Nanchang, China.,Department of Orthopedics, The First Affiliated Hospital of Nanchang University, Nanchang, China
| | - Xia Wu
- Department of College of Pharmacy, Nanchang University, Nanchang 330006, China
| | - Wei Li
- Department of Orthopedics, Artificial Joints Engineering and Technology, Research Center of Jiangxi Province, Nanchang, China.,Department of Orthopedics, The First Affiliated Hospital of Nanchang University, Nanchang, China
| | - Gendong Huang
- Department of Orthopedics, Artificial Joints Engineering and Technology, Research Center of Jiangxi Province, Nanchang, China.,Department of Orthopedics, The First Affiliated Hospital of Nanchang University, Nanchang, China
| | - Min Dai
- Department of Orthopedics, Artificial Joints Engineering and Technology, Research Center of Jiangxi Province, Nanchang, China.,Department of Orthopedics, The First Affiliated Hospital of Nanchang University, Nanchang, China
| | - Bing Zhang
- Department of Orthopedics, Artificial Joints Engineering and Technology, Research Center of Jiangxi Province, Nanchang, China.,Department of Orthopedics, The First Affiliated Hospital of Nanchang University, Nanchang, China
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Zhang B, Zou Y, Yang M, Niu G. Endovascular management of renal artery aneurysms induced by neurofibromatosis type 1: A case report. Medicine (Baltimore) 2017; 96:e8858. [PMID: 29382000 PMCID: PMC5708999 DOI: 10.1097/md.0000000000008858] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
RATIONALE Neurofibromatosis type 1 (NF-1) is an autosomal dominant disorder characterized by cafe au lait macules and neurofibromatosis. Renal artery aneurysms are relatively uncommon. Endovascular techniques are effective in treating renal aneurysms but successful cases are rarely reported in NF-1 adults. PATIENT CONCERNS The patient was one 23-year-old female presented with hypertension, multiple café-au-lait spots ≥15 mm, and plexiform neurofibroma. Renal artery aneurysms were found by ultrasound. DIAGNOSES NF-1 was diagnosed based on clinical manifestations and confirmed by gene test. Renal artery aneurysms were diagnosed based on computed tomography. INTERVENTIONS Bilateral renal artery angiography was performed and 3 aneurysms were found sequentially on the left anterior superior segmental artery. Microcoil embolization of aneurysms was undertaken. OUTCOMES The patient's blood pressure decreased after the procedure with reduction of medicine. A 3-month follow-up unilateral selective renal angiogram demonstrated little change in size of aneurysms, and no opacification of the aneurysmal sac was found. Serum creatinine remained in normal range at 3-month. LESSONS Successful endovascular treatment for NF-1 related renal artery aneurysms in adults is reported for the 1st time with preserved renal function and improved hypertension. Endovascular procedure is considered to be feasible and effective for renal artery aneurysms induced by NF-1.
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Gómez-Zuleta MA, Lúquez-Mindiola AJ. Neurofibromatosis tipo 1 y sangrado de intestino delgado. Reporte de caso. REVISTA DE LA FACULTAD DE MEDICINA 2017. [DOI: 10.15446/revfacmed.v65n4.59619] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
La neurofibromatosis tipo 1, o enfermedad de von Recklinghausen, es un desorden neurocutáneo hereditario con compromiso gastrointestinal en el 5-25% de los pacientes, siendo sintomático solo el 5%; se presenta posterior a las manifestaciones cutáneas y afecta en su mayoría el yeyuno. Los síntomas de esta enfermedad son dolor abdominal, obstrucción intestinal, perforación, diarrea, masa palpable y sangrado gastrointestinal alto o bajo.A continuación se reporta el caso de una mujer con sangrado gastrointestinal manifiesto secundario a neurofibromas plexiformes en yeyuno y se realiza una breve revisión de la literatura sobre compromiso gastrointestinal.
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Abstract
Esophageal neurofibroma is a rare type of benign esophageal tumor. We presented a case of a 63-year-old man with a 12-cm diameter upper-thoracic esophageal submucosal tumor. Surgery of a thoracotomy was performed to remove the lesion. The postoperative course was uneventful and the patient was discharged on the postoperative day 10. Immunohistochemical staining confirmed the diagnosis of esophageal neurofibroma.
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Affiliation(s)
- Men Yang
- Department of Thoracic Oncology, Sun Yat-sen University Cancer center, Guangzhou, Guangdong 510060, China
| | - Dongni Chen
- Department of Thoracic Oncology, Sun Yat-sen University Cancer center, Guangzhou, Guangdong 510060, China
| | - Xiaoyan Gao
- Department of Endoscopy, Sun Yat-sen University Cancer center, Guangzhou, Guangdong 510060, China
| | - Zhesheng Wen
- Department of Thoracic Oncology, Sun Yat-sen University Cancer center, Guangzhou, Guangdong 510060, China
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Farrugia FA, Martikos G, Tzanetis P, Charalampopoulos A, Misiakos E, Zavras N, Sotiropoulos D. Pheochromocytoma, diagnosis and treatment: Review of the literature. Endocr Regul 2017; 51:168-181. [DOI: 10.1515/enr-2017-0018] [Citation(s) in RCA: 47] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/01/2023] Open
Abstract
Abstract
Objective. We conducted an extensive review of the literature and tried to cite the most recent recommendations concerning the pheochromocytoma (PHEO).
Methods. Pub Med and Google Scholar databases were searched systematically for studies concerning pheochromocytomas (intra-adrenal paragangliomas) from 1980 until 2016. Bibliographies were searched to find additional articles.
Results. More than four times elevation of plasma fractionated metanephrines or elevated 24-h urinary fractionated metanephrines are keys to diagnosing pheochromocytoma. If the results are equivocal then we perform the clonidine test. If we have not done it already, we preferably do a CT scan and/or an MRI scan. The patient needs pre-treatment with α1-blockers at least 10–14 days before operation. Alternatives or sometimes adjuncts are Calcium Channels Blockers and/or β-Blockers. Several familial syndromes are associated with PHEO and genetic testing should be considered.
Conclusions. The biggest problem for pheochromocytoma is to suspect it in the first place. Elevated metanephrines establish the diagnosis. With the proper preoperative preparation the risks during operation and the postoperative period are minimal. If there is a risk of the hereditable mutation, it is strongly suggested that all the patients with pheochromocytoma need clinical genetic testing.
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Affiliation(s)
- FA Farrugia
- 3 University Department of Surgery, Attikon University Hospital , University of Athens, School of Medicine , Athens , Greece
| | - G Martikos
- 3 University Department of Surgery, Attikon University Hospital , University of Athens, School of Medicine , Athens , Greece
| | - P Tzanetis
- 3 University Department of Surgery, Attikon University Hospital , University of Athens, School of Medicine , Athens , Greece
| | - A Charalampopoulos
- 3 University Department of Surgery, Attikon University Hospital , University of Athens, School of Medicine , Athens , Greece
| | - E Misiakos
- 3 University Department of Surgery, Attikon University Hospital , University of Athens, School of Medicine , Athens , Greece
| | - N Zavras
- 3 University Department of Surgery, Attikon University Hospital , University of Athens, School of Medicine , Athens , Greece
| | - D Sotiropoulos
- 3 University Department of Surgery, Attikon University Hospital , University of Athens, School of Medicine , Athens , Greece
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Poble PB, Dalphin JC, Degano B. Severe dyspnea in a patient with neurofibromatosis type 1. Respir Med Case Rep 2017; 22:74-76. [PMID: 28702341 PMCID: PMC5491756 DOI: 10.1016/j.rmcr.2017.06.008] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2017] [Revised: 06/13/2017] [Accepted: 06/14/2017] [Indexed: 11/30/2022] Open
Abstract
Neurofibromatosis type 1 (NF1) is a genetic disease in which pulmonary complications are rare, but severe, especially pulmonary hypertension (PH). The mechanisms underlying the onset of PH in patients with NF1 are unclear and might be multifactorial. In particular, the frequent presence of pulmonary parenchymal lesions makes etiological diagnosis of PH difficult. We describe here the case of a patient with NF1 admitted to our clinic with dyspnea and right heart failure revealing severe pre-capillary PH. Parenchymal lesions were mild and PH was attributed to pulmonary vascular involvement. Clinical and hemodynamic conditions of the patient improved under pulmonary arterial hypertension-specific combination therapy. This case suggests that treatment of PH due to pulmonary vascular involvement in NF1 may be aligned with recommendations for PAH treatment.
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Affiliation(s)
- P B Poble
- Department of Respiratory Diseases, University Hospital of Besançon, Besançon, France
| | - J C Dalphin
- Department of Respiratory Diseases, University Hospital of Besançon, Besançon, France
| | - B Degano
- Department of Physiology and Respiratory Investigation, University Hospital of Besançon, Besançon, France
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Abstract
RATIONALE Neurofibromatosis type I (NF-I) accounts for approximately 90% of neurofibromatosis. NF-I is an autosomal dominant genetic disease which results from the gene mutation of NF-I situated in chromosome 17q11.2. PATIENT CONCERNS A 32-year-old lady presented with a giant wing like structure on her back which started growing from her childhood. DIAGNOSIS A diagnosis of NF-I was confirmed as she presented with multiple cutaneous nodules, multiple café-au-lait macules of different sizes, scoliosis deformity, and positive family history of neurofibroma. INTERVENTIONS Surgical excision of tumor and multiple Z plasty reconstruction of the back was carried out. OUTCOMES The excised neurofibroma weighed 6.7 kg containing thickened nerves, nerve roots, and circuitous vessels. The histopathological report confirmed plexiform and diffuse type cutaneous neurofibroma without any malignant transformation. Surgical excision and reconstruction with regular follow-up is an excellent choice of treatment for such a giant neurofibroma as in this case. LESSONS NF-I is a genetic disease which could present as a giant cutaneous neurofibroma. One of the treatment options for giant neurofibromas causing deformity and physical disability is by surgical excision and histopathological examination with regular follow-up for NF-I recurrence.
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Carrera S, Sancho A, Azkona E, Azkuna J, Lopez-Vivanco G. Hereditary pancreatic cancer: related syndromes and clinical perspective. Hered Cancer Clin Pract 2017; 15:9. [PMID: 28670351 PMCID: PMC5490219 DOI: 10.1186/s13053-017-0069-6] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2017] [Accepted: 06/21/2017] [Indexed: 02/07/2023] Open
Abstract
Pancreatic cancer is a very aggressive disease with a poor prognosis. The majority of them are attributed to sporadic causes, especially to many modifiable risk factors such as tobacco or alcohol abuse. The principal histologic subtype of pancreatic cancer is ductal adenocarcinoma. Pancreatic neuroendocrine tumors, which constitute a more indolent entity, represent second type of pancreatic cancer in terms of incidence. Individuals with a family history of pancreatic cancer carry an increased risk of developing the disease, which may be related to an underlying hereditary component. Unfortunately, in the majority of these families the suspected germline genetic cause responsible of the disease will not be identified, but approximately in a 20% of the cases a hereditary cancer predisposition syndrome with increased risk of pancreatic cancer development can be recognized. This review will be focused on the leading hereditary cancer syndromes related to pancreatic ductal adenocarcinoma and pancreatic neuroendocrine tumors. Additionally, we will try to explain clinical aspects related to the identification of germline mutations in pancreatic cancer patients and their potential implications in oncologic treatment decisions.
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Affiliation(s)
- Sergio Carrera
- Hereditary Cancer Genetic Counseling Unit- Medical Oncology Department, Cruces University Hospital, Plaza de Cruces s/n. 48903, Baracaldo, Bizkaia Spain
| | - Aintzane Sancho
- Medical Oncology Department, Cruces University Hospital, Baracaldo, Spain
| | - Eider Azkona
- Medical Oncology Department, Cruces University Hospital, Baracaldo, Spain
| | - Josune Azkuna
- Medical Oncology Department, Cruces University Hospital, Baracaldo, Spain
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Ilivitzki A, Glozman L, Lopez Alfonso R, Ofer A, Beck Razi N, Rotman Shapira M. Sonographic evaluation of renovascular hypertension in the pediatric population: State-of-the-art. JOURNAL OF CLINICAL ULTRASOUND : JCU 2017; 45:282-292. [PMID: 28370243 DOI: 10.1002/jcu.22467] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/25/2016] [Revised: 01/14/2017] [Accepted: 01/17/2017] [Indexed: 06/07/2023]
Abstract
Hypertension in children affects 2-5% of the pediatric population. Identifying secondary causes of hypertension is crucial, as some of these entities may be treatable. Renovascular hypertension accounts for 5-10% of the secondary causes of hypertension in children and is mainly related to fibromuscular dysplasia and neurofibromatosis type 1. Ultrasonographic evaluation of the kidneys, including Doppler interrogation, is the recommended primary screening tool. A comprehensive study of the upper abdomen and retroperitoneum allows for identification of additional underlying etiologies. The purpose of this review is to emphasize the different causes of renovascular hypertension in children one can diagnose during the initial ultrasonographic evaluation. © 2016 Wiley Periodicals, Inc. J Clin Ultrasound 45:282-292, 2017.
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Affiliation(s)
- Anat Ilivitzki
- Department of Diagnostic Imaging, Rambam Health Care Center, 38 Haag Str, Haifa, Israel
- Bruce Rappaport Faculty of Medicine, Technion Institute of Technology, Haifa, Israel
| | - Luda Glozman
- Department of Diagnostic Imaging, Rambam Health Care Center, 38 Haag Str, Haifa, Israel
| | - Rebeca Lopez Alfonso
- Department of Diagnostic Imaging, Rambam Health Care Center, 38 Haag Str, Haifa, Israel
| | - Amos Ofer
- Department of Diagnostic Imaging, Rambam Health Care Center, 38 Haag Str, Haifa, Israel
- Bruce Rappaport Faculty of Medicine, Technion Institute of Technology, Haifa, Israel
| | - Nira Beck Razi
- Department of Diagnostic Imaging, Rambam Health Care Center, 38 Haag Str, Haifa, Israel
- Bruce Rappaport Faculty of Medicine, Technion Institute of Technology, Haifa, Israel
| | - Mika Rotman Shapira
- Department of Diagnostic Imaging, Schneider Children's Medical Center of Israel, Petach Tikva, Israel
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
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Winter N, Rattay TW, Axer H, Schäffer E, Décard BF, Gugel I, Schuhmann M, Grimm A. Ultrasound assessment of peripheral nerve pathology in neurofibromatosis type 1 and 2. Clin Neurophysiol 2017; 128:702-706. [PMID: 28315612 DOI: 10.1016/j.clinph.2017.02.005] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2016] [Revised: 02/05/2017] [Accepted: 02/06/2017] [Indexed: 02/07/2023]
Abstract
OBJECTIVE The neurofibromatoses (NF) type 1 and 2 are hereditary tumor predisposition syndromes caused by germline mutations in the NF1 and NF2 tumor suppressor genes. In NF1 and 2, peripheral nerve tumors occur regularly. For further characterizing nerve ultrasound was performed in patients with NF1 and 2. METHODS Patients with established diagnosis of NF1 (n=27) and NF2 (n=10) were included. Ultrasound of peripheral nerves and cervical roots was performed during routine follow-up visits. Healthy volunteers were studied for comparison. RESULTS In patients with NF1, median cross-sectional area (CSA) of most nerves was significantly increased compared to controls and to NF2 due to generalized plexiform tumors, which arose out of multiple fascicles in 23 of 27 patients (85%). These were often accompanied by cutaneous or subcutaneous neurofibromas. In NF2, the overall aspect of peripheral nerves consisted of localized schwannomas (80%) and, apart from that, normal nerve segments. CONCLUSION Nerve ultrasound is able to visualize different nerve pathologies in NF1 and NF2. It is a precise and inexpensive screening method for peripheral nerve manifestation in neurofibromatosis and should be considered as the first choice screening imaging modality for all peripheral nerves within reach of non-invasive ultrasound techniques. SIGNIFICANCE Ultrasound patterns of peripheral nerve pathologies are described for the first time in a large cohort of patients with NF1 and NF2. It is a suitable screening tool and enables targeted MRI analysis.
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Affiliation(s)
- Natalie Winter
- Center of Neurology, Tübingen University Hospital and Hertie Institute for Clinical Brain Research, Eberhard-Karl University Tübingen, Tübingen, Germany
| | - Tim W Rattay
- Center of Neurology, Tübingen University Hospital and Hertie Institute for Clinical Brain Research, Eberhard-Karl University Tübingen, Tübingen, Germany; German Research Center for Neurodegenerative Diseases, (DZNE), Tübingen, Germany
| | - Hubertus Axer
- Hans Berger Department of Neurology, Jena University Hospital, Friedrich-Schiller University Jena, Germany
| | - Eva Schäffer
- Department of Neurology, Kiel University Hospital, Albrecht-University Kiel, Germany
| | - Bernhard F Décard
- Department of Neurology, Basel University Hospital, University Basel, Switzerland
| | - Isabel Gugel
- Department of Neurosurgery, Tübingen University Hospital, Eberhard-Karl University Tübingen, Germany; Center of Neurofibromatosis, Center of Rare Diseases Tübingen, Tübingen University Hospital, Eberhard-Karl University Tübingen, Germany
| | - Martin Schuhmann
- Department of Neurosurgery, Tübingen University Hospital, Eberhard-Karl University Tübingen, Germany; Center of Neurofibromatosis, Center of Rare Diseases Tübingen, Tübingen University Hospital, Eberhard-Karl University Tübingen, Germany
| | - Alexander Grimm
- Center of Neurology, Tübingen University Hospital and Hertie Institute for Clinical Brain Research, Eberhard-Karl University Tübingen, Tübingen, Germany.
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Tumor segmentation of whole-body magnetic resonance imaging in neurofibromatosis type 1 patients: tumor burden correlates. Skeletal Radiol 2017; 46:93-99. [PMID: 27815599 DOI: 10.1007/s00256-016-2522-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/31/2016] [Revised: 10/10/2016] [Accepted: 10/23/2016] [Indexed: 02/02/2023]
Abstract
OBJECTIVE Segmentation of whole-body MRI (WBMRI) to assess the feasibility, quantitate the total tumor volume (tumor burden) in patients with neurofibromatosis type 1 (NF1) and examine associations with demographic, disease-related and anthropomorphic features. METHODS A consecutive series of patients with NF1 underwent WBMRI and were reviewed for tumors. Tumors were segmented using a semiautomated software-based tool. Tumors were classified as superficial or deep and discrete or plexiform. Segmentation times were recorded. Segmentation yielded the quantity and tumor burden of superficial, internal and plexiform tumors. Correlations between segmentation data and demographic, disease-related and anthropomorphic features were examined. RESULTS Fifteen patients were evaluated (42.3 ± 13.6 years, 10 female, 5 male). Segmentation times were a median of 30 min and yielded 2,328 tumors (1,582 superficial, 746 internal and 23 plexiform). One tumor was malignant. Tumor counts ranged from 14 to 397. Tumor burden ranged from 6.95 cm3 to 571 cm3. Individual tumor volume ranged from 0.0120 cm3 to 298 cm3. Significant correlation was found between the total volume of superficial tumors and height (ρ = 0.5966, p < 0.02). Male patients had higher overall tumor burdens (p < 0.05) and higher superficial tumor burden (p < 0.03). Patients with negative family history had more tumors (p < 0.05). CONCLUSION Segmentation of WBMRI in patients with NF1 is feasible and elucidates meaningful relationships among disease phenotype, anthropomorphic and demographic features.
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Abstract
Although the pancreas is affected by only a small fraction of known inherited disorders, several of these syndromes predispose patients to pancreatic adenocarcinoma, a cancer that has a consistently dismal prognosis. Still other syndromes are associated with neuroendocrine tumors, benign cysts, or recurrent pancreatitis. Because of the variability of pancreatic manifestations and outcomes, it is important for clinicians to be familiar with several well-described genetic disorders to ensure that patients are followed appropriately. The purpose of this review was to briefly describe the hereditary syndromes that are associated with pancreatic disorders and neoplasia.
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Affiliation(s)
- Meredith E Pittman
- Department of Pathology and Laboratory Medicine, Weill Cornell Medical College, Starr 1031A, 525 East 68th Street, New York, NY 10065, USA
| | - Lodewijk A A Brosens
- Department of Pathology, University Medical Center Utrecht, Heidelberglaan 100, 3584 CX, Utrecht, The Netherlands
| | - Laura D Wood
- Department of Pathology, The Sol Goldman Pancreatic Cancer Research Center, Johns Hopkins University School of Medicine, CRB2 Room 345, 1550 Orleans Street, Baltimore, MD 21231, USA.
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Quintas A, Aragão Morais J, Martins J, Gonçalves FB, Rodrigues G, Abreu R, Ferreira R, Camacho N, Ferreira ME, Albuquerque e Castro J, Mota Capitão L. Hematoma cervical e hemotórax espontâneos no contexto de neurofibromatose tipo I. ANGIOLOGIA E CIRURGIA VASCULAR 2016. [DOI: 10.1016/j.ancv.2016.02.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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Lee WJ, Park SM, Kim BW, Kim JS, Ji JS, Choi H. [Solitary Neurofibroma of the Sigmoid Colon Presenting as a Subepithelial Tumor Successfully Removed by Endoscopic Resection]. THE KOREAN JOURNAL OF GASTROENTEROLOGY 2016; 68:45-8. [PMID: 27443624 DOI: 10.4166/kjg.2016.68.1.45] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
Abstract
Neurofibromas are benign, slow-growing nerve sheath tumors of the peripheral nervous system, arising from Schwann cells, and classically associated with neurofibromatosis type 1 (Nf1, von Recklinghausen's disease). They occur rarely in the gastro-intestinal tract as isolated neoplasms, outside the classical clinical feature of neurofibromatosis. We herein present an isolated colonic neurofibroma without any systemic signs of neurofibromatosis. A 59-year-old female came to our hospital for constipation. On physical examination, general appearance showed no definite skin lesions. A subepithelial tumor measuring 0.8 cm was detected at the distal descending colon on colonoscopy. The lesion was removed completely by endoscopic resection. Microscopic examination showed proliferation of spindle cells in the mucosa and infiltration of inflammatory cells. Immunohistochemical staining was positive for S-100 protein. The above morphological and immunohistochemical characteristics were consistent with a diagnosis of a solitary neurofibroma of the sigmoid colon.
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Affiliation(s)
- Won Jik Lee
- Department of Internal Medicine, Incheon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Incheon, Korea
| | - Sung Min Park
- Department of Internal Medicine, Incheon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Incheon, Korea
| | - Byung Wook Kim
- Department of Internal Medicine, Incheon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Incheon, Korea
| | - Joon Sung Kim
- Department of Internal Medicine, Incheon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Incheon, Korea
| | - Jeong Seon Ji
- Department of Internal Medicine, Incheon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Incheon, Korea
| | - Hwang Choi
- Department of Internal Medicine, Incheon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Incheon, Korea
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Paschoal JKSF, Paschoal FM, de Lima FT, Pinho RS, Vilanova LCP, Bor-Seng-Shu E, Masruha MR. Detection of Cerebral Vasculopathy by Transcranial Doppler in Children With Neurofibromatosis Type 1. J Child Neurol 2016; 31:351-6. [PMID: 26184486 DOI: 10.1177/0883073815595080] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/21/2015] [Accepted: 06/13/2015] [Indexed: 11/17/2022]
Abstract
Neurofibromatosis type 1 is characterized by nerve sheath neurofibromas associated with a number of additional clinical features, including cerebrovascular disease. The aim of this study was to use transcranial Doppler as a screening method for identifying cerebral vasculopathy in children with neurofibromatosis type 1. Forty children with neurofibromatosis type 1, aged 5 to 18 years old, were examined by transcranial Doppler. Patients presenting with hemodynamic features of arterial stenosis/occlusion on transcranial Doppler underwent magnetic resonance angiography to confirm the findings. Magnetic resonance angiography was performed on 4 children who exhibited a transcranial Doppler hemodynamic pattern indicative of cerebral vasculopathy. Among these cases, 2 presented internal carotid artery stenosis/occlusion, 1 had bilateral middle cerebral artery stenosis, and 1 presented a normal magnetic resonance angiography result. Transcranial Doppler can be used routinely in the investigation of cerebrovascular disease in neurofibromatosis type 1 patients, where magnetic resonance angiography can be subsequently applied to confirm the diagnosis, further contributing to the prevention of cerebrovascular events.
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Affiliation(s)
| | - Fernando Mendes Paschoal
- Laboratory for Neurosonology and Cerebral Hemodynamics, Division of Clinical Neurosurgery, Hospital das Clinicas, Sao Paulo University Medical School, Sao Paulo, Brazil
| | - Fernanda Teresa de Lima
- Department of Neurology and Neurosurgery, Federal University of São Paulo, São Paulo, Brazil
| | - Ricardo Silva Pinho
- Department of Neurology and Neurosurgery, Federal University of São Paulo, São Paulo, Brazil
| | | | - Edson Bor-Seng-Shu
- Laboratory for Neurosonology and Cerebral Hemodynamics, Division of Clinical Neurosurgery, Hospital das Clinicas, Sao Paulo University Medical School, Sao Paulo, Brazil
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Video-assisted thoracoscopic surgery for localized neurofibroma of the esophagus: case report and review of the literature. Int Surg 2015; 98:461-5. [PMID: 24229042 DOI: 10.9738/intsurg-d-12-00021.1] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Esophageal submucosal tumors are less common than other gastrointestinal tract tumors. Leiomyoma is the most common benign esophageal SMT, accounting for more than 70% of these tumors. We report on a case of a 56-year-old woman with a 3-cm diameter midthoracic esophageal submucosal tumor. Magnetic resonance imaging suggested leiomyoma or neurofibroma. Video-assisted thoracoscopic surgery was performed to enucleate the tumor from the esophageal wall by splitting the muscle layers. The postoperative course was uneventful, and the patient was discharged on postoperative day 8. Immunohistochemical staining confirmed the diagnosis of esophageal neurofibroma. Gastrointestinal tract involvement of neurofibromatous lesions is rare and occurs most frequently as a systemic manifestation of von Recklinghausen disease. Cases of localized esophageal neurofibroma with prior or subsequent evidence of generalized neurofibromatosis have rarely been documented. This is a rare case of isolated esophageal neurofibroma without classic systemic manifestations of generalized neurofibromatosis, and it is the first reported case treated by video-assisted thoracoscopic surgery.
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Faucheron JL, Trilling B. Surgery for a large obstructive pelvic tumour associated with neurofibromatosis. Colorectal Dis 2014; 15:1316. [PMID: 23869427 DOI: 10.1111/codi.12358] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/23/2013] [Accepted: 04/28/2013] [Indexed: 02/08/2023]
Affiliation(s)
- J-L Faucheron
- Department of Colorectal Surgery, University Hospital, BP 217, 38043, Grenoble, France; Joseph Fourier University, Grenoble, France.
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Trilling B, Faucheron JL. Intestinal obstruction in von Recklinghausen's disease. Colorectal Dis 2014; 16:762-8. [PMID: 24766607 DOI: 10.1111/codi.12649] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/08/2013] [Accepted: 02/07/2014] [Indexed: 02/08/2023]
Abstract
AIM Gastrointestinal manifestations occur in up to 25% of patients with neurofibromatosis type 1. This review reports all published cases of acute intestinal obstruction due to neurofibromatosis type 1 and identifies mechanisms of obstruction, the nature of the tumour and the outcome. METHOD A systematic review of the literature on acute intestinal obstruction due to neurofibromatosis type 1 was performed by searching the major electronic databases. All relevant references were reviewed for possible inclusion. All the references of the relevant articles were screened for any further articles that were missed in the initial search. RESULTS We identified 25 articles from 1972 to 2013 reporting 25 patients with von Recklinghausen's disease who underwent laparotomy for acute intestinal obstruction. Three further patients were operated on in our institution. The mean age of the patients was 44.2 years and the male/female ratio 15/13. The mechanisms of obstruction were intrinsic obstruction (16), extrinsic obstruction (8) and intussusception (4). Histology was reported to show neurofibroma (19), gastrointestinal stromal tumour (5) and adenocarcinoma (4). Among patients whose outcome was mentioned (17), 10 were asymptomatic after a mean follow-up of 1.5 years. CONCLUSION Acute bowel obstruction is a rare manifestation of neurofibromatosis type 1. Surgery is often necessary to treat the complication and to determine the exact nature of the tumour and the prognosis.
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Affiliation(s)
- B Trilling
- Colorectal Unit, Department of Surgery, University Hospital, Grenoble, Cedex, France
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Giant neurofibroma in the right lower limb of a 26-year-old woman: report of a case. Int Surg 2014; 97:71-7. [PMID: 23102003 DOI: 10.9738/cc2.1] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023] Open
Abstract
Neurofibromatosis (NF) is a genetically inherited, autosomal-dominant disease with an incidence of 1 in 3000 live births. There are two types of NF, NF 1 and NF 2, and NF 1 is the most common. This study reports on the diagnosis, treatment, and related family medical history of a rare case with NF-1 in the right lower limb.
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Affiliation(s)
- David M Shafer
- Division of Oral and Maxillofacial Surgery, University of Connecticut School of Dental Medicine, 263 Farmington Avenue, Farmington, CT 06030, USA.
| | - Lisa Marie Di Pasquale
- Division of Oral and Maxillofacial Surgery, University of Connecticut School of Dental Medicine, 263 Farmington Avenue, Farmington, CT 06030, USA
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50
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Lapere C, Copin MC, Lahoche A, Pruvot FR, Gnemmi V. [An unusual renal arterial lesion]. Ann Pathol 2014; 34:344-6. [PMID: 25132447 DOI: 10.1016/j.annpat.2014.04.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2013] [Revised: 03/25/2014] [Accepted: 04/10/2014] [Indexed: 11/17/2022]
MESH Headings
- Actins/analysis
- Adolescent
- Angioplasty, Balloon
- Antihypertensive Agents/therapeutic use
- Aorta, Abdominal
- Fibromuscular Dysplasia/complications
- Fibromuscular Dysplasia/diagnosis
- Fibromuscular Dysplasia/pathology
- Humans
- Hypertension, Renovascular/drug therapy
- Hypertension, Renovascular/etiology
- Hypertension, Renovascular/surgery
- Kidney Transplantation
- Male
- Myocytes, Smooth Muscle/chemistry
- Myocytes, Smooth Muscle/pathology
- Neointima/pathology
- Nephrectomy
- Neurofibromatosis 1/complications
- Renal Artery/pathology
- Renal Artery Obstruction/complications
- Renal Artery Obstruction/surgery
- Renal Artery Obstruction/therapy
- Transplantation, Autologous
- Transplantation, Heterotopic
- Vena Cava, Inferior
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Affiliation(s)
- Camille Lapere
- Institut de pathologie, centre hospitalier régional et universitaire de Lille, avenue Oscar-Lambret, 59037 Lille, France.
| | - Marie-Christine Copin
- Institut de pathologie, centre hospitalier régional et universitaire de Lille, avenue Oscar-Lambret, 59037 Lille, France; Faculté de médecine Henri-Warembourg, université de Lille 2, 59000 Lille, France
| | - Annie Lahoche
- Service de pédiatrie, hôpital Jeanne-de-Flandre, centre hospitalier régional et universitaire de Lille, avenue Eugène-Avinée, 59037 Lille, France
| | - François-René Pruvot
- Service de chirurgie digestive et transplantation, hôpital Claude-Huriez, centre hospitalier régional et universitaire de Lille, 59037 Lille, France; Faculté de médecine Henri-Warembourg, université de Lille 2, 59000 Lille, France
| | - Viviane Gnemmi
- Institut de pathologie, centre hospitalier régional et universitaire de Lille, avenue Oscar-Lambret, 59037 Lille, France; Faculté de médecine Henri-Warembourg, université de Lille 2, 59000 Lille, France
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