Female, 10 years old, with neurofibromatosis type I, headache and vision changes, assess for any change in the right facial plexiform neurofibroma and for any new tumors. Redemonstrated is a large infiltrative homogeneously enhancing plexiform neurofibroma involving the soft tissues of the right head and face. As before, the lesion involves or infiltrates the right temporalis muscle with extension along the muscle into the infratemporal fossa, as well as the subcutaneous tissues of the right frontotemporal and periorbital scalp. There has been no significant interval change in the size or geographic extent of this lesion.Although the plexiform neurofibroma abuts the lateral wall of the right orbit, no intraorbital extension is seen. Globes are round and symmetric. The extraocular muscles demonstrate normal signal characteristics and pattern of enhancement. The optic nerves, tracts and chiasm are within normal limits and show no evidence of any tumoral involvement. No intraconal abnormalities are detected.Scattered ill-defined areas of FLAIR hyperintensity are redemonstrated involving the thalami and to lesser extent the globus pallidi, brainstem and cerebellar peduncles. No new intracranial lesions are seen. No pathologic parenchymal enhancement is detected. There are no abnormal extra-axial fluid collections. The ventricles are normal in size and morphology.Ill-defined enhancement is seen within the paramedian and left suboccipital soft tissues of the upper neck. This is nonspecific and unchanged.
1.Stable plexiform neurofibroma involving the right face and scalp.2.Stable appearance of scattered foci of NF-related abnormal signal intensity within the brain.3.No evidence of optic pathway tumor.