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==Causes==
==Causes==
[[Plexiform neurofibroma]] may be caused by the bi-allelic inactivation of the [[neurofibromatosis type I]] tumor suppressor gene.<ref name=radio> Neurofibroma. Dr Bruno Di Muzio and Dr Maxime St-Amant et al. Radiopaedia.org 2015. http://radiopaedia.org/articles/neurofibroma </ref><ref name="pmid7550323">{{cite journal |vauthors=Colman SD, Williams CA, Wallace MR |title=Benign neurofibromas in type 1 neurofibromatosis (NF1) show somatic deletions of the NF1 gene |journal=[[Nature Genetics]] |volume=11 |issue=1 |pages=90–2 |year=1995 |pmid=7550323 |doi=10.1038/ng0995-90 |url=http://dx.doi.org/10.1038/ng0995-90 |issn= |accessdate=2015-11-16}}</ref>
[[Plexiform neurofibroma]] may be caused by the bi-allelic inactivation of the [[neurofibromatosis type I]] tumor suppressor gene.<ref name=radio> Neurofibroma. Dr Bruno Di Muzio and Dr Maxime St-Amant et al. Radiopaedia.org 2015. http://radiopaedia.org/articles/neurofibroma </ref><ref name="pmid7550323">{{cite journal |vauthors=Colman SD, Williams CA, Wallace MR |title=Benign neurofibromas in type 1 neurofibromatosis (NF1) show somatic deletions of the NF1 gene |journal=[[Nature Genetics]] |volume=11 |issue=1 |pages=90–2 |year=1995 |pmid=7550323 |doi=10.1038/ng0995-90 |url=http://dx.doi.org/10.1038/ng0995-90 |issn= |accessdate=2015-11-16}}</ref>
==Differential Diagnosis==
Neurofibroma must be differentiated from [[schwannoma]], [[dermatofibrosarcoma protuberans]] (DFSP), [[ganglioneuroma]], and [[melanocytic nevus]].<ref name=radio> Neurofibroma. Dr Bruno Di Muzio and Dr Maxime St-Amant et al. Radiopaedia.org 2015. http://radiopaedia.org/articles/neurofibroma </ref>
==Epidemiology and Demographics==
Neurofibroma usually affects individuals between 20 and 30 years of age.<ref name="pmid15544900">{{cite journal |vauthors=Pilavaki M, Chourmouzi D, Kiziridou A, Skordalaki A, Zarampoukas T, Drevelengas A |title=Imaging of peripheral nerve sheath tumors with pathologic correlation: pictorial review |journal=[[European Journal of Radiology]] |volume=52 |issue=3 |pages=229–39 |year=2004 |pmid=15544900 |doi=10.1016/j.ejrad.2003.12.001 |url=http://linkinghub.elsevier.com/retrieve/pii/S0720048X03003735 |issn= |accessdate=2015-11-13}}</ref> Neurofibroma affects men and women equally.<ref name=radio> Neurofibroma. Dr Bruno Di Muzio and Dr Maxime St-Amant et al. Radiopaedia.org 2015. http://radiopaedia.org/articles/neurofibroma </ref>
==Risk Factors==
There are no established risk factors for neurofibroma.
==Screening==
According to the the U.S. Preventive Service Task Force (USPSTF), there is insufficient evidence to recommend routine [[screening]] for neurofibroma.<ref>Neurofibroma. U.S. Preventive Service Task Force (USPSTF) 2015. http://www.uspreventiveservicestaskforce.org/BrowseRec/Search?s=neurofibroma </ref>
==Prognosis==
[[Prognosis]] of neurofibroma is generally excellent. If left untreated, 10% of patients with [[plexiform neurofibroma]]s may progress to develop [[malignant peripheral nerve sheath tumor]] (MPNST).<ref name="pmid12898075">{{cite journal |author=Mautner VF, Friedrich RE, von Deimling A, Hagel C, Korf B, Knöfel MT, Wenzel R, Fünsterer C. |title=Malignant peripheral nerve sheath tumours in neurofibromatosis type 1: MRI supports the diagnosis of malignant plexiform neurofibroma. |journal=American Journal of Pathology |volume=45 |issue=9 |pages=618–25 |year=2003 |pmid=12898075 |doi=10.1007/s00234-003-0964-6}}</ref>





Revision as of 20:46, 16 November 2015

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Shanshan Cen, M.D. [2]

Overview

A neurofibroma is a benign nerve sheath tumor in the peripheral nervous system.

Classification

Neurofibroma may be classified into 3 subtypes: localised neurofibroma, diffuse neurofibroma, and plexiform neurofibroma.[1]

Pathophysiology

On gross pathology, a nonencapsulated superficial mass is the characteristic finding of localised or diffuse neurofibroma; whereas the "bag of worms" appearance is the characteristic finding of plexiform neurofibroma.[2] On microscopic histopathological analysis, spindle cells with wavy nuclei without pleomorphism, wire-like collagen, moderate increase of cellularity vis-a-vis normal dermis, and mast cells are characteristic findings of neurofibroma.[3][4]

Causes

Plexiform neurofibroma may be caused by the bi-allelic inactivation of the neurofibromatosis type I tumor suppressor gene.[1][5]

Differential Diagnosis

Neurofibroma must be differentiated from schwannoma, dermatofibrosarcoma protuberans (DFSP), ganglioneuroma, and melanocytic nevus.[1]

Epidemiology and Demographics

Neurofibroma usually affects individuals between 20 and 30 years of age.[6] Neurofibroma affects men and women equally.[1]

Risk Factors

There are no established risk factors for neurofibroma.

Screening

According to the the U.S. Preventive Service Task Force (USPSTF), there is insufficient evidence to recommend routine screening for neurofibroma.[7]

Prognosis

Prognosis of neurofibroma is generally excellent. If left untreated, 10% of patients with plexiform neurofibromas may progress to develop malignant peripheral nerve sheath tumor (MPNST).[8]



References

  1. 1.0 1.1 1.2 1.3 Neurofibroma. Dr Bruno Di Muzio and Dr Maxime St-Amant et al. Radiopaedia.org 2015. http://radiopaedia.org/articles/neurofibroma
  2. Wilkinson LM, Manson D, Smith CR (2004). "Best cases from the AFIP: plexiform neurofibroma of the bladder". Radiographics : a Review Publication of the Radiological Society of North America, Inc. 24 Suppl 1: S237–42. doi:10.1148/rg.24si035170. PMID 15486243. Retrieved 2015-11-13.
  3. Bernthal, NM.; Jones, KB.; Monument, MJ.; Liu, T.; Viskochil, D.; Randall, RL. (2013). "Lost in translation: ambiguity in nerve sheath tumor nomenclature and its resultant treatment effect". Cancers (Basel). 5 (2): 519–28. doi:10.3390/cancers5020519. PMID 24216989.
  4. Staser, K.; Yang, FC.; Clapp, DW. (2010). "Mast cells and the neurofibroma microenvironment". Blood. 116 (2): 157–64. doi:10.1182/blood-2009-09-242875. PMID 20233971. Unknown parameter |month= ignored (help)
  5. Colman SD, Williams CA, Wallace MR (1995). "Benign neurofibromas in type 1 neurofibromatosis (NF1) show somatic deletions of the NF1 gene". Nature Genetics. 11 (1): 90–2. doi:10.1038/ng0995-90. PMID 7550323. Retrieved 2015-11-16.
  6. Pilavaki M, Chourmouzi D, Kiziridou A, Skordalaki A, Zarampoukas T, Drevelengas A (2004). "Imaging of peripheral nerve sheath tumors with pathologic correlation: pictorial review". European Journal of Radiology. 52 (3): 229–39. doi:10.1016/j.ejrad.2003.12.001. PMID 15544900. Retrieved 2015-11-13.
  7. Neurofibroma. U.S. Preventive Service Task Force (USPSTF) 2015. http://www.uspreventiveservicestaskforce.org/BrowseRec/Search?s=neurofibroma
  8. Mautner VF, Friedrich RE, von Deimling A, Hagel C, Korf B, Knöfel MT, Wenzel R, Fünsterer C. (2003). "Malignant peripheral nerve sheath tumours in neurofibromatosis type 1: MRI supports the diagnosis of malignant plexiform neurofibroma". American Journal of Pathology. 45 (9): 618–25. doi:10.1007/s00234-003-0964-6. PMID 12898075.


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