Reason: Evaluate plexiform neurofibroma History: Patient with NF-1 and large plexiform tumor causing pain Due to technologist error, the superior extent of the plexiform neurofibroma was not included in its entirety on the field of view. We will attempt to have the patient return for repeat sequences that cover the entire cranial extent of the tumor in addition to the sagittal sequences that were not obtained as part of the routine University of Chicago protocol. Note is made of an extensive plexiform neurofibroma involving the soft tissues of the distal thigh, knee, and leg. The largest mass is again noted within the lateral aspect of the popliteal fossa, measuring approximately 8.6 x 4.9 cm, appearing similar to the previous study, following remeasurement. Medial to this large mass, is a second mass measuring approximately 5 x 3.6 cm in the transverse dimension, previously 3.9 x 3.3 cm. A third mass, resulting in scalloping of the posterolateral aspect of the proximal tibia, measures approximately 2.6 x 2.0 cm, appearing similar to the prior study when accounting for positional differences. A fourth lesion along the lateral aspect of the mid fibular diaphysis measures approximately 3.8 x 2.1 cm, appearing similar in size when accounting for positional differences. Additional smaller neurofibromas are noted surrounding the distal femoral diaphysis and along the lateral and posterior margins of the distal femoral metaphysis, as well as within the biceps femoris muscle and along the sciatic nerve. Multiple additional neurofibromas are noted within all of the compartments of the leg, appearing similar to the prior study. There is fatty infiltration of the deep posterior compartment musculature of the leg, appearing similar to the prior study.
Incomplete study showing plexiform neurofibromas as described above. We will attempt to have the patient return for further images so that the proximal extent of the tumor can be scanned along with the remainder of the lesion.