Male, 29 years old, history of neurofibromatosis type I with intermittent severe pain in the right arm. Extensive plexiform neurofibroma formation is seen along all of the cervical nerve roots including throughout the brachial plexi. The right brachial plexus is more extensively involved than the left. Bilateral heterogeneous masses are present within the apical thoraces with resultant inferior displacement of the lung apices. The mass on the left measures up to 60 mm, and the mass on the right measures up to 42 mm. A scoliotic deformity of the cervicothoracic junction is evident at the level of the apical masses.Numerous additional small tumors are evident within the mediastinum, deep spaces of the neck, and even perhaps the left laryngeal folds. The trachea is deviated to the left and mildly narrowed secondary to paratracheal tumor at the level of the thoracic inlet. Numerous cutaneous and subcutaneous nodules are evident.
Extensive plexiform neurofibroma formation throughout the brachial plexi affecting the right side more than the left.Large bilateral apical thorax masses are seen. Given their heterogeneous appearance and disproportionate size relative to the other visualized neurofibromas, the possibility of malignant degeneration should be considered. Correlation with prior imaging if available would be helpful.Numerous additional small neurofibromas are evident within the cutaneous and subcutaneous tissues as well as the deep spaces of the neck.