Diffuse Neurofibroma: The Pugnacious Scalp Tumor Identified by the Histopathological Exam and Role of Expander for Diseased-Free Margins: A Case Report
Author(s): Muhammad Usman, Ying Cen and Ai Zhong
Abstract
The diffuse neurofibroma is the inherited and rarest variation of Neurofibroma. The Diffuse neurofibroma is commonly found in children and adolescents. The tumor can develop anywhere in the peripheral nervous system and cranial nerves. Diffuse neurofibroma is highly infiltrative with inadequate borders; tumor most likely affects body part such as the head and neck. We have presented the case of a nine-year-old boy who suffered head pain and discomfort for years. He appeared to our plastic surgery department and is accompanied by an obvious tumor on the back of his scalp. MRI revealed a large mass on the scalp. An incisional biopsy was performed and based on histopathological findings; diffuse neurofibroma was diagnosed after clinical and laboratory observation in brief. The treatment included a two-step step technique, and in the first step the tissue expander implantation was done, and in the second step the surgical excision of the tumor. The patient is asymptomatic after 3 years. This is a rare variant that must be distinguished from other types of neurofibroma to prompt treatment and management. Furthermore, our case report the deep understanding of the guideline and management by providing clinical evidence of the utility of histopathological analysis and which give plastic surgeons in smaller settings a serious warning to follow the proper guideline.