title: Pediatric plexiform neurofibromas: impact on morbidity and mortality in neurofibromatosis type 1.
abstract: OBJECTIVE
  To characterize morbidity, mortality, and surgical outcomes in pediatric patients with symptomatic plexiform neurofibromas (PNFs).
  
  
  METHODS
  We conducted retrospective analysis of data from clinical records of surgical history and other neurofibromatosis type 1 (NF1)-related complications in children with PNFs seen at Cincinnati Children's Hospital Medical Center between 1997 and 2007.
  
  
  RESULTS
  A total of 154 children with NF1 and PNFs were identified. Children with symptomatic PNFs had increased incidence of other NF1-related tumors (P < .05). Patients with NF1 and PNFs had a higher mortality rate (5/154, 3.2%) when compared with patients without or with asymptomatic PNFs (2/366, 0.5%; P = .024). The most common morbidities leading to surgeries were neurologic, disfigurement, orthopedic, and airway complaints. Less extensive resection predicted a shorter interval to second surgery (P < .0019). The highest recurrence was seen in tumors located in the head, neck, and thorax (P < .001).
  
  
  CONCLUSIONS
  These findings quantify the increased risk for additional tumors and mortality associated with symptomatic PNFs. Surgical interventions were required in many cases and resulted in added morbidity in some cases. Patients with PNFs were more likely to benefit from surgery when the indications were airway compression or disfigurement.
authors: Division of Human Genetics, Department of Pediatrics, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA.
authors: Carlos E
authors: CE
authors: Prada
authors: Fatima A
authors: FA
authors: Rangwala
authors: Lisa J
authors: LJ
authors: Martin
authors: Anne M
authors: AM
authors: Lovell
authors: Howard M
authors: HM
authors: Saal
authors: Elizabeth K
authors: EK
authors: Schorry
authors: Robert J
authors: RJ
authors: Hopkin
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D018317:Nerve Sheath Neoplasms / Q000150:complications; D018318:Neurofibroma, Plexiform / Q000150:complications* / Q000401:mortality / Q000473:pathology / Q000601:surgery; D009456:Neurofibromatosis 1 / Q000150:complications* / Q000401:mortality; D010524:Peripheral Nervous System Neoplasms / Q000150:complications*