Reason: Evaluate intramuscular NF lesions in left lower leg History: pain/evidence of intramuscular lesions at time of surgery Note is made of multiple round masses within the subcutaneous and soft tissues of the left leg consistent with the patient's known history of neurofibromatosis. The largest lesion is situated within the muscle belly of the medial gastrocnemius measuring approximately 2.1 x 1.7 cm (image 39; series 9), which was not definitely seen on the prior examination from 2009 and does not have the characteristic target sign on pre or post contrast imaging. While this may represent a neurofibroma, the possibility of a MPNST cannot be excluded. There are multiple additional masses involving the soleus and plantaris musculature as well as within the peroneal musculature consistent with patient's history of neurofibromatosis. There are also innumerable cutaneous and subcutaneous lesions consistent with the patient's history of neurofibromatosis. On the large field-of-view images, note is made of multiple enhancing foci of signal abnormality within the subcutaneous and soft tissues of the right leg also consistent with the patient's history of neurofibromatosis. Again seen is slight bowing of the tibia, unchanged. No bone marrow signal abnormality is identified.
2.1 cm mass within the medial head of the gastrocnemius as described above, new from the prior examination performed in 2009. While this may represent a neurofibroma, the possibility of a MPNST (malignant peripheral nerve sheath tumor) cannot be excluded. Multiple additional masses in the left leg as well as subcutaneous and cutaneous nodules, consistent with the patient's known history of neurofibromatosis.