Multidimensional ultrasound and computed tomography imaging support in bleeding plexiform neurofibromatosis of the scalp: A case report and literature review

Ximena Wortsman; Nelson Lobos; Rodrigo De la Parra; Laura Carreno

doi:10.4103/0019-5154.160522

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Year : 2015 | Volume : 60 | Issue : 4 | Page : 421

Multidimensional ultrasound and computed tomography imaging support in bleeding plexiform neurofibromatosis of the scalp: A case report and literature review

Ximena Wortsman¹, Nelson Lobos², Rodrigo De la Parra², Laura Carreno³
¹ Department of Radiology and Department of Dermatology, Institute for Diagnostic Imaging and Research of the Skin and Soft Tissues, Clinica Servet, Faculty of Medicine, University of Chile, Santiago, Chile
² Deparment of Dermatology, Hospital Clinico U. Chile, Faculty of Medicine, University of Chile, Santiago, Chile
³ Department of Pathology, Dermopathology Section, Hospital Clinico U. Chile, Faculty of Medicine, University of Chile, Santiago, Chile

Correspondence Address:
Dr. Ximena Wortsman
Department of Radiology and Department of Dermatology, Institute for Diagnostic Imaging and Research of the Skin and Soft Tissues, Clinica Servet, Faculty of Medicine, University of Chile, Santiago, Chile, Lo Fontecilla 201, of 734, Las Condes, Santiago
Chile

Source of Support: None, Conflict of Interest: None

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DOI: 10.4103/0019-5154.160522

Active bleeding in plexiform neurofibromatosis can be a life-threatening complication in neurofibromatosis type 1 (NF1). The prompt imaging support of 2D-3D ultrasound (US) and computed tomography (CT) during the active hemorrhage phase of cutaneous neurofibromas has not been previously reported. We report a case with NF1 who experienced a sudden swelling in the parieto-temporal region that corresponded to a massive and active hemorrhage within a plexiform neurofibroma. The US and CT imaging characteristics of this bleeding tumor are shown. Active hemorrhage in a plexiform neurofibroma of the scalp appeared in US as a heterogeneous hypodermal mass. CT demonstrated a fully hyperdense soft tissue mass. These characteristics differ from the non-complicated or old hemorrhagic imaging appearances of scalp plexiform neurofibromas and encourage prompt surgical treatment. This case report demonstrates the usefulness of imaging support in the early diagnosis of this hemorrhagic complication of NF1 in the scalp and also stimulates multispecialty management.

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