Extracranial diffuse neurofibroma with intracranial extension

Diffuse scalp neurofibromas: Case series and Clinicoradiological characteristics of a rare vascular lesion

Diffuse neurofibroma of the head and neck are rare tumours which have unique clinical and radiological findings. Presurgical diagnosis is important as these lesions are usually highly vascular and pre-operative embolisation can reduce the risk of intra-operative haemorrhage. In this article we describe four cases; two which underwent pre-operative embolisation, which should aid the reader in successfully diagnosing this entity before biopsy/surgery.

Diffuse neurofibroma with hypertrichosis in a toddler

Diffuse neurofibroma is a rare type of neurofibroma uncommonly reported in infancy. It is a slow growing tumor originating in the peripheral nerve sheath. We present the case of a 17-month-old boy with diffuse neurofibroma of the scalp associated with hypertrichosis. His genetic and clinical workup for neurofibromatosis was negative.

Diffuse Neurofibroma: An Uncommon Cause of Alopecia

Alopecia (hair loss) is reported to be associated with infection, genetics, hormonal changes, drugs, or inflammation. The most frequent causes of hair loss in pediatric patients include tinea capitis, alopecia areata, traction alopecia, and trichotillomania. In the adult population, causes to be considered are alopecia areata and hair loss associated with systemic disease and hormonal influence. The clinician must be able to separate the types and causes of hair loss into those that reflect primary dermatologic conditions and those that represent a reaction to systemic disease. Benign cutaneous tumors have also been known to develop alopecia via occupying the place for hair follicles or tumor-induced inflammatory responses. However, the mechanism of alopecia by neurofibroma (NF) has not been well investigated. We present a 32-year-old patient who developed scalp plaque with alopecia within 6 years. He denies any itching or pain in the area, and has not tried any treatments. In this study, the unusual association between NF and alopecia is shown.

Solitary giant diffuse neurofibroma of the scalp with calvarial defect

Neurofibromas of the scalp can have protean presentations. Most of the swellings are small, solitary and are easily diagnosed clinically. Diffuse swellings on the other hand are rare and are commonly seen in adults. The skull defects with these swellings are also rarely reported in the absence of neurofibromatosis. There is only one report of child having diffuse neurofibroma with skull defect. We report a second case in literature in a child with progressive, painful, diffuse neurofibroma along with calvarial defect.

Diffuse neurofibroma of scalp

A 22-year-old man presented with a large, soft, compressible swelling in the right occipito-parietal region. Fine needle aspiration cytology revealed blood only. The lesion was excised and histopathology studies revealed it to be a diffuse neurofibroma.

Diffuse infiltrative neurofibroma: a clinical, radiological, and histological conundrum

Diffuse infiltrative neurofibroma is a rare clinical entity that can pose a diagnostic challenge not only due to its rarity but also due to its varied clinical, radiological, and histological features. Our case illustrates how this entity may be misdiagnosed on clinical and pathological examination. Radiological imaging plays a critical and collaborative role in guiding clinicians and pathologists when faced with this challenging diagnosis.

Diffuse neurofibroma--an uncommon cause of alopecia

Although infrequent, alopecia can be caused by benign cutaneous tumours. Neurofibromas are common benign tumors that originate in the peripheral nerve sheath. Diffuse neurofibroma is a rare variant of neurofibroma that is thought to occur mainly in the head and neck of children and young adults. Histology generally shows an infiltrative tumor, composed of spindle cells in the dermis and subcutaneous tissue. Despite being rare, malignant transformation has been reported. The association between diffuse neurofibromas and neurofibromatosis type 1 still remains to be determined since some authors question the low incidence usually described. We report the case of a 42-year-old man who had a diffuse neurofibroma on the scalp presenting as alopecic plaques.

Multidisciplinary management of a giant plexiform neurofibroma by double sequential preoperative embolization and surgical resection

Plexiform neurofibromas are benign tumors originating from subcutaneous or visceral peripheral nerves, which are usually associated with neurofibromatosis type 1. Giant neurofibromas are very difficult to manage surgically as they are extensively infiltrative and highly vascularized. These types of lesions require complex preoperative and postoperative management strategies. This case report describes a 22-year-old female with a giant plexiform neurofibroma of the lower back and buttock who underwent pre-operative embolization and intraoperative use of a linear cutting stapler system to assist with haemostasis during the surgical resection. Minimal blood transfusion was required and the patient made a good recovery. This case describes how a multidisciplinary management of these large and challenging lesions is technically feasible and appears to be beneficial in reducing perioperative blood loss and morbidity. Giant neurofibroma is a poorly defined term used to describe a neurofibroma that has grown to a significant but undefined size. Through a literature review, we propose that the term "giant neurofibroma" be used for referring to those neurofibromas weighing 20% or more of the patient's total corporal weight.

Diffuse neurofibroma of the scalp presenting as circumscribed alopecic patch

Neurofibroma is a benign tumor of the peripheral nerve sheath characterized by proliferation of Schwann cells, perineural cells and endoneurial fibroblasts. Different types of neurofibromas can be identified, including localized, plexiform, and diffuse types. Diffuse neurofibroma is an uncommon form of neurofibroma that occurs primarily in children and young adults. The head and neck regions are the most common sites of involvement. Diffuse neurofibroma is an ill-defined infiltrative lesion and tends to involve the skin and subcutaneous tissues. It produces localized thickening and induration of the skin. We present a case of a 12-year-old boy who had a diffuse neurofibroma on the scalp since the age of 2 years.

Diffuse scalp malignant peripheral nerve sheath tumor with intracranial extension in a patient with neurofibromatosis type 1

We describe a rare scalp malignant peripheral nerve sheath tumor (MPNST) with cranial destruction and intracranial extension in a 52-year-old male with neurofibromatosis type 1 (NF1). The scalp tumor measured 22cm×18cm, with local surface ulceration. Skin examination revealed many café-au-lait spots and small, hard dermal nodules on the trunk. CT scans revealed the scalp tumor to have heterogeneous density with partial destruction of the right parietal cranium; on T1-weighted MRI the scalp tumor displayed heterogeneous hypointensity, whereas on T2-weighted and fluid-attenuated inversion recovery MRI it was hyperintense. The tumor was excised totally and the scalp reconstructed using a skin flap isolated from the lateral aspect of the left thigh. Histological examination confirmed that the tumor was an MPNST. The patient recovered uneventfully and was well at the 6-month follow-up, with no local or other tumor recurrence noted.

A case of diffuse neurofibroma of the scalp

A neurofibroma is a benign tumor of the peripheral nerve sheath characterized by proliferation of Schwann cells, perineural cells, and endoneurial fibroblasts. Different types of neurofibromas can be identified, including localized, plexiform, and diffuse types. Neurofibromas can involve any site on the body skin. The diffuse variant is rare and occurs primarily in children and young adults. It involves the skin and subcutaneous tissue in a plaque-like fashion on the head and neck regions. We present a case of a 10-year-old boy who had a diffuse neurofibroma on the scalp.

Imaging appearance of diffuse neurofibroma

OBJECTIVE

The purposes of this study were to describe the imaging appearance of diffuse neurofibroma in 10 patients and to summarize demographic data on a large group of patients.

MATERIALS AND METHODS

Retrospective review of the pathology and radiology teaching databases at two institutions yielded the cases of 339 patients with a pathologic diagnosis of diffuse neurofibroma. Diagnostic-quality images were available for 10 patients. Images from MRI (n = 8), CT (n = 5), and sonographic (n = 1) examinations were evaluated for lesion location, size, depth of involvement, growth pattern, and intrinsic signal intensity, attenuation, or echogenicity. Demographic information, associated lesions, and tumor location were recorded for all patients.

RESULTS

Among 10 patients with images, eight of whom had neurofibromatosis, diffuse neurofibroma involved the skin and subcutaneous tissues (n = 9) and frequently extended to the fascia over muscle (n = 6). Plaquelike (n = 5) and infiltrative (n = 3) growth patterns were most common. One lesion had a mixed growth pattern. Prominent internal vascularity was common (n = 5). MRI signal intensity and CT attenuation were typically nonspecific. Enhancement was intense in all five patients with contrast-enhanced MR examinations. Including patients with and those without images, 349 diffuse neurofibromas were present in 339 patients. The mean patient age was 35.1 years. Lesions involved the extremities (n = 120), trunk (n = 122), head and neck (n = 98), and deep structures (n = 9).

CONCLUSION

Diffuse neurofibroma frequently grows as a plaquelike or infiltrative lesion involving the skin and subcutaneous tissues. Prominent internal vascularity is common. There is a much wider soft-tissue and age distribution and association with neurofibromatosis than previously reported.

Diffuse neurofibroma on the lower back

Diffuse neurofibroma is an uncommon form of neurofibroma, which occurs principally in children and young adults. This tumor presents most often in the head and neck region. We have seen a young girl with a diffuse neurofibroma on the lower back that was successfully excised.