Neurofibromatosis, type 1 (von Recklinghausen's disease). Please assess the margins of diffuse neurofibroma of occiput and upper neck which has grown significantly in past year. The extensive, infiltrative skin/subcutaneous mass involving the posterior aspect of the head/upper neck has not significantly changed in overall size though this is difficult to quantify. It is slightly smaller along its superior aspect (history of resection in 2015) while it has become slightly thicker and more nodular in the right retroauricular region. An underlying soft tissue nodule in the left suboccipital region has grown and now measures 13 mm in diameter (compared to 5 mm previously). This may represent a reactive lymph node but may also represent a localized neurofibroma. The underlying skull is intact.The brain shows no abnormality. The CSF-containing spaces, including the ventricles, are normal in size.The orbits are normal. Minimal mucosal thickening is present in the left maxillary and ethmoid sinuses without fluid, most likely of no significance. Mastoid air cells are clear.
A large, diffuse neurofibroma involving the back of the hand and the upper neck has slightly grown in the right retroauricular region since 2007. There is no involvement of the underlying skull.