A 19 year-old female (Patient #1) with enlarging left plexiform neurofibroma which transformed to a malignant peripheral nerve sheath tumor. A. Plain radiograph shows a large left neck plexiform neurofibroma (large arrows) and suggests destruction of the posterior elements at C7 (small arrows). B. Coronal T1 without contrast shows the large left plexiform neurofibroma (arrows) with poor delineation of the bony elements. C. Axial MDCT without contrast demonstrates destruction of the T1 vertebral body, lamina and transverse process as well as the T1 rib (arrows). D. 3D volume rendered images with destruction of the bony structures at the C7 and T1 vertebral bodies (black arrows) and adjacent left T1 rib (white arrows).