Abstract

BackgroundNeurofibromatosis type 1 (NF1) is a genetic disorder characterized by a predisposition to develop multiple benign tumors. A major feature of NF1 is the development of localized cutaneous neurofibromas. Cutaneous neurofibromas manifest in > 99% of adults with NF1 and are responsible for major negative effects on quality of life. Previous reports have correlated increased burden of cutaneous neurofibromas with age and pregnancy, but longitudinal data are not available to establish a quantitative natural history of these lesions. The purpose of this study is to conduct a prospective natural history study of 22 adults with NF1 over an 8-year period to quantify cutaneous neurofibroma number and size.ResultsThe average monthly increase in volume for cutaneous neurofibromas was 0.37 mm3 in the back region (95% CI (0.23, 0.51), p < 0.0001), 0.28 mm3 in the abdominal region (95% CI (0.16, 0.41), p < 0.0001), and 0.21 mm3 in the arm/leg region (95% CI (0.08, 0.34), p = 0.0022). The number of cutaneous neurofibromas significantly increased in the back (slope = 0.032, p = 0.011) and abdominal (slope = 0.018, p = 0.026) regions, while the leg/arm regions retained a positive trend (slope = 0.004, p = 0.055).ConclusionsThe number and volume of cutaneous neurofibromas significantly increased over an 8-year timespan; however, the rate of increase is variable by individual and body region. These findings may provide insight into cutaneous neurofibroma development and benefit researchers considering clinical trials targeting cutaneous neurofibromas.

Highlights

  • Neurofibromatosis type 1 (NF1) is a genetic disorder characterized by a predisposition to develop multiple benign tumors

  • Visibility of cutaneous neurofibromas (cNFs) are associated with major negative effects on quality of life for individuals with NF1 [4,5,6]

  • The development of non-surgical treatment and clinical trials directed at cutaneous neurofibromas has been hampered by the difficulty in measuring and counting cNFs and lack of detailed information on the natural history of the lesions

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Summary

Introduction

Neurofibromatosis type 1 (NF1) is a genetic disorder characterized by a predisposition to develop multiple benign tumors. A major feature of NF1 is the development of localized cutaneous neurofibromas. Cutaneous neurofibromas manifest in > 99% of adults with NF1 and are responsible for major negative effects on quality of life. Localized cutaneous neurofibromas (cNFs) derive from peripheral nerves and manifest within the dermis and subcutaneous tissue. These lesions are not life threatening, they can lead to significant morbidity. The development of non-surgical treatment and clinical trials directed at cutaneous neurofibromas has been hampered by the difficulty in measuring and counting cNFs and lack of detailed information on the natural history of the lesions

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