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Massive intratumor hemorrhage in facial plexiform neurofibroma
Author(s) -
Tung TungChain,
Chen YuRay,
Chen KuoTing,
Chen ChienTzung,
BendorSamuel Richard
Publication year - 1997
Publication title -
head and neck
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.012
H-Index - 127
eISSN - 1097-0347
pISSN - 1043-3074
DOI - 10.1002/(sici)1097-0347(199703)19:2<158::aid-hed13>3.0.co;2-9
Subject(s) - plexiform neurofibroma , medicine , surgery , neurofibroma , hemostasis , neurofibromatosis , complication , radiology
Background Plexiform neurofibromatosis is a feature of von Recklinghausen's disease. Head and neck lesions may produce varying degrees of cosmetic and functional deformity. However, life‐threatening hemorrhage into facial plexiform neurofibromas has not been previously reported. Method We report two patients with von Recklinghausen's disease who experienced massive hemorrhage into facial neurofibromas, one following a blunt injury and the other without a known initiating event. Results Conservative management did not stop the hemorrhage into facial neurofibromas in either instance. Surgical exploration was mandated for hemorrhage control and evacuation of blood clots. Hemostasis was attained by a combination of hypotensive anesthesia and chromic catgut suture ligatures. Conclusions These case reports demonstrate a potentially lethal complication in patients with facial plexiform neurofibroma. Where a competent and experienced interventional neuroradiologist is not available, surgical exploration should be undertaken to control bleeding. © 1997 John Wiley & Sons, Inc. Head Neck 19 : 158–162, 1997.