Unusual form of the distal bone defect of ulna with neurofibromatosis type 1: A case report

Tibial Dysplasia in Neurofibromatosis-1: A Rare Case Report and Review of Literature

Background

Neurofibromatosis-1 (NF-1) is a neurocutaneous disorder, primarily affecting the skin and nervous system. Concomitant multi-system involvement is also seen. Orthopedic manifestations of NF-1 are one area that is understudied and underreported, highlighting the importance of this case report.

Case Report

A 16-year-old male presented with painless swelling on the posteromedial aspect of the lower right tibia, which was confirmed to be a dysplastic mass on biopsy. Physical examination also revealed cafe au lait macules and axillary freckling, leading to a diagnosis of NF-1.

Discussion

Bony lesions in NF-1 patients mainly include the spine and tibia. Congenital tibial dysplasia is commonly associated with NF-1 and may progress to pseudoarthrosis if early management is not started. Treatment modalities include excision, bracing, and fixation.

Conclusion

Further research is required to have a more comprehensive view of NF-1 and orthopedics, to diagnose and manage such bony complications.

Bone deformities in patients with neurofibromatosis type 1: Single-center experience

BACKGROUND

Neurofibromatosis type 1 (NF-1) is the most common neurocutaneous syndrome with an autosomal dominant inheritance. However, half of the cases are de novo mutations. Involvement of bone, skin (cafe au lait macules), as well as ocular and tumoral formations is also associated with NF-1. Here, we present our case series of patients with bone deformities.

METHODS

The medical files of patients with NF-1 who were followed up by the same doctor in the pediatric neurology outpatient clinic over 2 years were retrospectively analyzed.

RESULTS

Overall, 19 girls and 13 boys were diagnosed with NF-1. Of these 32 patients, 12 (nine girls, three boys) were found to have bone pathologies. The average age was of these patients with bone pathology was 7.5 and 9.5 years. Scoliosis, bowing, short stature, and long bone cysts were found in descending order of frequency. Severe adhesions in the hands and feet as well as phalangeal hypoplasia were noted in one patient.

CONCLUSION

NF-1 requires a multidisciplinary approach. Routine follow-up is very important as it is known that deformities that affect different systems may appear or increase with age. Severe hand and foot anomalies seen in one of our patients did not seem to be associated with NF-1.