Neurofibromatosis-T1 with arteriovenous malformation and aneurysms in rapidly growing tumor mass diagnosed by angiothomograghy
Abstract
Introduction: Neurofibromatosis-type 1 is a chromosome 17 mutation induced disease. Some clinical manifestations include skin nodules, cafe au lait spots, Lisch nodules, skeletal manifestations, and cognitive deficiency. The condition can be accompanied by vascular complications; more frequent occlusion types, and less frequent hemorrhagic with arteriovenous malformation (AVM), fistulas, and aneurysms.
Objective: To present a new case of NF1 with a mass of rapid growth in the posterior cranial-cervical region with AVM, giant arterial and venous aneurysms diagnosed by multi-slice angiotomography.
Clinical case: A female patient of 52 years of age with a history of hypertension and (NF1) comes with a tumoral mass of 15 cm, approximately 20 days of progress. The mass is situated in the posterior left cranial-cervical region that relates to mild traumatic, soft, and painful to palpation lesion, accompanied by amaurosis, cephalalgia, left facial paralysis, and transitory loss of consciousness. Multi-slice angiotomography revealed a high left vertebral arteriovenous malformation, featuring a 3 cm arteriovenous fistula with a giant venous aneurysm in the posterior occipital region. Additionally, it showed a fusiform aneurysm of the left intracranial vertebral artery and another 2 cm extracranial paravertebral aneurysm on the same side at the C1-C2 level. Surgical or interventional treatment was considered, but taking into account the patient's general condition, it was decided to follow up with symptomatic treatment.
Conclusions: In cases of rapidly growing tumor mass in patients with neurofibromatosis or plexiform neurofibroma, especially with a history of minor trauma, the possibility of vascular malformations should be excluded. Multi-slice angiotomography is a simple technique that can provide valuable information.
DeCS: NEUROFIBROMATOSIS 1; SKULL; ANEURYSM; ARTERIOVENOUS FISTULA; NEUROFIBROMA, PLEXIFORM.
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