PMC5801573_01
A 17-year-old girl with neurofibromatosis who presented with pain in the left shoulder. Plain radiograph of the left shoulder anteroposterior view showing multilocular osteolytic lesion (arrow) in the left humerus involving metaphysis and upper shaft with sclerotic margins.
JCIS-8-3-g003.jpg
PMC5801573_01_JCIS-8-3-g003.jpg
F1
Osteolytic lesions were also noted in the medial cortex of upper humeral shaft [Figure 1].
A 17-year-old girl with neurofibromatosis who presented with pain in the left shoulder. (a) Ultrasound showing well-defined hypoechoic solid mass with lobulated outlines (arrow) in the left axilla suggestive of plexiform neurofibroma. (b) Ultrasound image showing discontinuity in adjoining cortex of upper humerus (red arrow).
JCIS-8-3-g004.jpg
PMC5801573_01_JCIS-8-3-g004.jpg
F2
There was discontinuity in the cortex on posteromedial and posterolateral aspect of upper humeral shaft with an intraosseous well-defined hypoechoic soft-tissue lesion measuring approximately 32 mm x 25 mm [Figure 2a and b].
A 17-year-old girl with neurofibromatosis who presented with pain in the left shoulder. (a and b) Plain computed tomography image of the left shoulder in soft-tissue window shows hypodense soft-tissue density mass with lobulated outlines (black arrow) in the left axilla extending in intermuscular fat planes suggestive of plexiform neurofibroma. (c and d) computed tomography image with bony window shows multilocular osteolytic lesions with sclerotic margins (white arrow) in adjoining humeral head and upper shaft suggestive of intraosseous neurofibroma.
JCIS-8-3-g005.jpg
PMC5801573_01_JCIS-8-3-g005.jpg
F3
Multiple well-defined osteolytic lesions of variable sizes with sclerotic margins were noted in inferior portion of humeral head, upper metaphysis, and upper shaft [Figures 3 and 4].
A 17-year-old girl with neurofibromatosis who presented with pain in the left shoulder. (a) Coronal and sagittal (b) plain computed tomography scan of left humerus at bony window showing multilocular osteolytic lesions (arrow) with sclerotic margins in adjoining humeral head and upper shaft suggestive of intraosseous neurofibroma.
JCIS-8-3-g006.jpg
PMC5801573_01_JCIS-8-3-g006.jpg
F4
Multiple well-defined osteolytic lesions of variable sizes with sclerotic margins were noted in inferior portion of humeral head, upper metaphysis, and upper shaft [Figures 3 and 4].
A 17-year-old girl with neurofibromatosis who presented with pain in the left shoulder. (a) Magnetic resonance imaging left shoulder coronal T1 weighted showing plexiform neurofibroma in the left axilla (white arrow) and intraosseous neurofibroma (black arrow) in adjoining humerus appearing hypointense on T1 weighted. (b) Magnetic resonance imaging left shoulder coronal T2 weighted showing plexiform neurofibroma (white arrow) in the left axilla and intraosseous neurofibroma in adjoining humerus (black arrow) appearing hyperintense on T2 weighted. (c and d) Magnetic resonance imaging left shoulder coronal proton density fat suppressed sequence (PDFS) showing plexiform neurofibroma (white arrow) in the left axilla and intraosseous neurofibroma in adjoining humerus (black arrow) hyperintense on PDFS.
JCIS-8-3-g007.jpg
PMC5801573_01_JCIS-8-3-g007.jpg
F5
Diagnosis of plexiform neurofibroma in the left axilla was made with intraosseous neurofibroma [Figures 5 and 6].
A 17-year-old girl with neurofibromatosis who presented with pain in the left shoulder. (a and b) Magnetic resonance imaging left shoulder axial PDFS showing plexiform neurofibroma in the left axilla and adjacent to left humerus (white arrow), intraosseous neurofibroma (black arrow) in adjoining humerus appearing hyperintense on PDFS. (c and d) Magnetic resonance imaging left shoulder sagittal PDFS showing plexiform neurofibroma in left axilla and adjacent to left humerus (white arrow), intraosseous neurofibroma (black arrow) in adjoining humerus appearing hyperintense on PDFS.
JCIS-8-3-g008.jpg
PMC5801573_01_JCIS-8-3-g008.jpg
F6
Diagnosis of plexiform neurofibroma in the left axilla was made with intraosseous neurofibroma [Figures 5 and 6].