title: Giant thoracic neurofibromatosis type 1 with massive intratumoral haemorrhage: a case report.
abstract: A 44-year-old man known to have neurofibromatosis type 1 (NF1) presented with an acute enlargement of a long-standing pedunculated thoracic mass and a 4.5 kg weight gain. He was recently treated with anticoagulation for a newly diagnosed atrial fibrillation. Intratumoral bleed was thus suspected to explain the sudden enlargement. Chest computerised tomography confirmed the presence of a large extrathoracic tumour of soft tissue density compatible with a diagnosis of neurofibromatosis and a recent massive intratumoral haematoma. Perioperative angiography demonstrated remarkable hypervascularity. The treatment plan involved embolisation and surgical resection. The histological specimen confirmed a diagnosis of neurofibromatosis type I without malignant transformation. Neurofibromatosis associated with an intratumoral haemorrhage is rare. This is the first scientific report of a massive intratumoral bleed in NF1 subsequent to anticoagulant administration. Anticoagulation should be monitored very closely in neurofibromatosis patients due to their propensity to bleed secondary to the abnormal vascular intima.
authors.affiliation: Division of Plastic and Reconstructive Surgery, MUHC (McGill University Health Centre), McGill University, Montreal General Hospital, Montreal, Quebec, Canada.
authors.forename: L
authors.initials: L
authors.lastname: Lessard
authors.forename: Ali
authors.initials: A
authors.lastname: Izadpanah
authors.forename: H B
authors.initials: HB
authors.lastname: Williams
mesh_terms: D000328:Adult; D000925:Anticoagulants / Q000009:adverse effects*; D001281:Atrial Fibrillation / Q000188:drug therapy; D006470:Hemorrhage / Q000139:chemically induced / Q000473:pathology* / Q000601:surgery; D006801:Humans; D008297:Male; D009456:Neurofibromatosis 1 / Q000150:complications / Q000473:pathology* / Q000601:surgery; D013899:Thoracic Neoplasms / Q000150:complications / Q000473:pathology* / Q000601:surgery; D016896:Treatment Outcome
chemical_list: D000925:Anticoagulants