History of malignant peripheral nerve sheath tumor, known left femoral diaphyseal tumor now here with increasing pain over the left femur tumor site. Assess for bony abnormality over proximal femur. Multiple soft tissue masses are compatible with the stated diagnosis of neurofibromatosis. There is a chronic fracture deformity of the distal femoral diaphysis resulting in posteromedial bowing. There is a defect of the proximal femur at the level of the lesser trochanter representing extrinsic erosion by an adjacent soft tissue mass seen on the prior MRI study. The femoral neck is thinned which may also reflect chronic extrinsic pressure erosion. A small round lucency in the distal femoral diaphysis may either be posttraumatic in etiology or due to the patient's underlying neurofibromatosis. Moderate osteoarthritis affects the knee.
Radiographic features of neurofibromatosis as described above with chronic pressure erosions of the proximal femur, and old fracture deformity of the distal femur.