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Case report
Appendiceal neurofibroma and diverticula in a neurofibromatosis type 1 patient with chronic right lower quadrant pain
  1. Katrien Van de Steen1,
  2. Robert Riedl2,
  3. Sébastien Strypstein3 and
  4. Evert-Jan Boerma1
  1. 1Abdominal Surgery, Zuyderland Medical Centre, Heerlen, Limburg, The Netherlands
  2. 2Pathology, Zuyderland Medical Centre, Heerlen, Limburg, The Netherlands
  3. 3Abdominal Surgery, University Hospitals Leuven, Leuven, Flanders, Belgium
  1. Correspondence to Dr Sébastien Strypstein; strypstein.md{at}gmail.com

Abstract

Neurofibromatosis type 1 (NF1, Von Recklinghausen disease) is an autosomal dominant disease with a birth incidence of 1/2500–3000. The most common presentations of NF1 are cutaneous presentations like café-au-lait spots and neurofibromas. 5%–25% of patients with NF1 have gastrointestinal manifestations of the disease. Appendiceal neurofibroma are extremely rare and only a few cases are described in literature. An appendectomy is indicated because of high risk of appendicitis and malignant transformation. We report the case of a 74-year-old male patient with a history of NF1 with chronic right lower quadrant pain. Successive imaging scans showed suspicion of chronic appendicitis. A diagnostic laparoscopy, resulting in a laparoscopic appendectomy was performed without complications. Histopathology showed appendiceal neurofibroma and diverticula. The postoperative course was uneventful. In patients with NF1 with right lower quadrant pain benign appendiceal neurofibroma should be included in the differential diagnosis. A diagnostic laparoscopy should be performed followed by an appendectomy.

  • gastrointestinal surgery
  • pathology
  • genetics

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Footnotes

  • Twitter @seb_strypstein

  • Contributors KVdS designed the paper, reviewed the literature and wrote the paper. RR contributed important ideas. E-JB and SS revised the paper.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent for publication Obtained.

  • Provenance and peer review Not commissioned; externally peer reviewed.