Lachkar Adnane, El Farhaoui Amine, Najib Abdeljaouad, Yacoubi Hicham
Department of Orthopedic Surgery B, Hospital University Center Mohammed VI, Oujda, Morocco.
Ann Med Surg (Lond). 2023 Mar 9;85(3):470-472. doi: 10.1097/MS9.0000000000000181. eCollection 2023 Mar.
Solitary neurofibroma is a rare tumor that occurs particularly in the head and trunk. It is mostly small and rarely exceeds 2 cm.
A 61-year-old female patient complained about an increasingly extended mass with pain in the right knee for about 14 months. Physical examination reveals a big, solid mass in front of the medial condyle, measuring about 14×12 cm. Tinel's sign was positive on mass percussion. MRI showed a well-circumscribed oval mass with low signal on T1 and high signal on T2-weighted images. A surgical biopsy was performed, and immunohistochemistry confirmed the diagnosis of solitary neurofibroma. Surgical excisions were performed with good outcomes.
A giant solitary neurofibroma is exceptional. The knee location is even rarer. Immunohistochemistry is the only way to confirm the diagnosis.
Giant neurofibromas need a complete surgical excision. Until today, there were no other alternative therapies for these tumors.
孤立性神经纤维瘤是一种罕见肿瘤，尤其好发于头颈部和躯干。肿瘤大多较小，很少超过2厘米。
一名61岁女性患者因右膝肿物逐渐增大伴疼痛就诊，病程约14个月。体格检查发现内侧髁前方有一巨大实性肿物，大小约14×12厘米。肿物叩击试验（Tinel征）阳性。磁共振成像（MRI）显示为边界清晰的椭圆形肿物，T1加权像呈低信号，T2加权像呈高信号。行手术活检，免疫组化确诊为孤立性神经纤维瘤。手术切除后效果良好。
巨大孤立性神经纤维瘤较为罕见，发生于膝关节部位的更是少见。免疫组化是确诊的唯一方法。
巨大神经纤维瘤需要完整手术切除。目前，针对这类肿瘤尚无其他替代治疗方法。
