Neurofibromatosis type I. History of plexiform neurofibroma of the neck/brachial plexus and left arm. The infiltrative, nodular mass along/following the left brachial plexus and extending into the supraclavicular region, which is compatible with plexiform neurofibroma, is not significantly changed since the January 2014 examination. It is also not significantly changed in size compared to the more remote examination from 2012 though appears slightly less confluent. For example, the component of the lesion which is posterior to the left common carotid artery measures coronally 2.0 cm x 1.7 cm (series #501, image #20) compared to 1.9 cm x 1.8 cm in 2012. The plexiform neurofibroma is associated with denervation changes in the left subscapularis muscle.A well-circumscribed T2-hyperintense lesion anterior to the left scapula measures up to 1.7 cm axial and is not significantly changed since the previous examination done is not appropriately covered in all 3 imaging planes. Numerous smaller nodules are present on both sides of the neck without significant change. Some of them probably represent neurofibromas while others represent small lymph nodes.The airway is preserved. Cervical carotid flow voids are preserved.There is an incompletely imaged infiltrative mass involving the anterior right temporal region extending lateral to the right orbit, which has progressed since the previous examination, now measuring up to 1.7 cm in thickness compared to 0.7 cm on the 2012 examination. This is associated with a small questioned defect involving the lateral wall of the right orbit but no definite intraorbital extension of the mass.Signal abnormality involving the deep gray nuclei and the brainstem is only partly included on the current examination.
1.The component of the left plexiform neurofibroma in the neck and supraclavicular region has not significantly changed since January 2014 or January 2012 examinations. Please refer to the report of the MRI of the left upper extremity for details regarding the remainder of the plexiform neurofibroma.2.The incompletely imaged infiltrative mass involving the anterior right temporal region has increased since 2012 examination, likely an additional plexiform neurofibroma. Signal abnormality involving the deep gray nuclei and the brainstem also incompletely imaged on the current examination. Dedicated brain and orbits MRI can provide additional details regarding these findings.