title: Recurrent massive subcutaneous hemorrhage in neurofibromatosis type 1: a case report.
abstract: Neurofibromatosis type 1 (NF-1) is an autosomal dominant disorder that has three major features: multiple neural tumors, cafe-au-lait spots, and pigmented iris hamartomas (Lisch nodules). The purpose of this case report is to advise physicians of the danger associated with the progression of fast-onset massive hemorrhage to hemodynamic instability, which mandates rapid treatment to prevent the development of a life-threatening condition. A 64-yr-old woman with NF-1 was admitted to the Emergency Department (ED) because of a rapidly growing, 10 x 5 x 3 cm-sized mass on the left back area. She had previously undergone surgery for a large subcutaneous hematoma, which had developed on her right back area 30 yr before. She became hemodynamically unstable with hypotension during the next 3 hr after admission to ED. Resuscitation and blood transfusion were done, and the hematoma was surgically removed. The mass presented as a subcutaneous, massive hematoma with pathologic findings of neurofibroma. We report a case of NF-1 that presented as recurrent, massive, subcutaneous hemorrhage on the back region combined with hypovolemic shock.
authors.affiliation: Department of Emergency Medicine, College of Medicine, Inha University, Incheon, Korea.
authors.forename: Sung Hoon
authors.initials: SH
authors.lastname: Baek
authors.forename: Ji Hye
authors.initials: JH
authors.lastname: Kim
authors.forename: Jun Sig
authors.initials: JS
authors.lastname: Kim
authors.forename: Seung Baik
authors.initials: SB
authors.lastname: Han
authors.forename: Jung Soo
authors.initials: JS
authors.lastname: Cho
authors.forename: Yong Han
authors.initials: YH
authors.lastname: Yoon
authors.forename: Lucia
authors.initials: L
authors.lastname: Kim
mesh_terms: D003937:Diagnosis, Differential; D005260:Female; D006406:Hematoma / Q000209:etiology / Q000473:pathology; D006470:Hemorrhage / Q000209:etiology* / Q000473:pathology; D006801:Humans; D008875:Middle Aged; D009456:Neurofibromatosis 1 / Q000150:complications* / Q000473:pathology; D012008:Recurrence; D012871:Skin Diseases / Q000209:etiology* / Q000473:pathology; D014057:Tomography, X-Ray Computed