Multidisciplinary treatment of a giant craniofacial neurofibroma with intratumoral hemorrhage.

A 19-year-old man presented with a rapidly growing right craniofacial lump and headache for 9 days, with vision loss in the right eye and no other manifestation of neurofibromatosis or neurologic disturbance. Imaging revealed a giant lesion with intratumoral hematoma and adjacent bone dysplasia (figure, A and B). The tumor and the involved right eye (figure, C) were removed following preoperative embolization. The wound was repaired using dorsal and lateral cervicothoracic flap grafting. Pathologic examination revealed a neurofibroma without malignant transformation. Solitary giant craniofacial neurofibromas with intratumoral hemorrhage are rare and require multidisciplinary care for optimal outcome (figure, D). Early intervention is preferable.