Female 3 years old with a history of NF1 and multiple plexiform fibromas. Evaluate for change in size or structure of left chest and axilla plexiform fibroma.EXAMINATION: MR chest without and with IV contrast 4/12/2016 LUNGS AND PLEURA: The lungs appear normal.MEDIASTINUM AND HILA: Normal cardiac size. The infiltrative chest wall mass extends into the left anterosuperior mediastinum resulting in anterior displacement of the left common carotid artery and internal jugular vein. There is also extension into the posterior mediastinum as on the previous exam. The upper mediastinum is shifted to the right with rightward displacement of the trachea. The arch vessels and tributaries to the left brachiocephalic vein are patent. Overall, findings in the mediastinum are similar to the previous exam.CHEST WALL: The large, infiltrative T1 and T2 hyperintense mass involving the neural foramina on the left from C5 to T5, intradural tumor on the left results in slight rightward displacement of the spinal cord at the cervicothoracic junction similar to the previous exam. The mass involves the left lateral neck, chest wall, axilla and upper arm extending outside the field of view. There is extension into the pleural space as on the prior exam. There has been a small increase in size of the mass in the AP dimension.There are postoperative changes related to thoracotomy and C5-C7 laminoplasty. Hyperlordosis at C5-7 and kyphosis at the cervicothoracic junction have increased since the prior MRI but were better characterized on the recent neck radiograph.An additional T1 and T2 hyperintense lesions in the right T7 neural foramina and several lesions in the posterior intercostal spaces at multiple levels likely represent additional nerve sheath tumors and are unchanged.UPPER ABDOMEN: The partially visualized liver and spleen are normal.OTHER
1.Slight increase in AP dimension but otherwise no change in the large, infiltrative plexiform neurofibroma involving the left C5-T5 neural foramina, lateral neck, chest wall, mediastinum and axilla.2.Please also see the separately dictated report for MRI of the face and neck.