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Multiple Bilateral Spinal Neurofibromas in an Adult with Nonfamilial NF‑1

A 29‐year‐old male, a known case of nonfamilial NF‐1, presented with complaint of weakness of both hands for the past 4 months. There were multiple subcutaneous nodules present over the body, with no family history of similar features. On examination, power in both upper limbs was 4/5 and both lower limbs 5/5 on the Medical Research Council Scale, with increased tone, exaggerated reflexes and graded sensory loss below C2 dermatome. MRI demonstrated multiple tumors compressing the cervical cord at various levels [Figure 1a], with enlargement of neural foramina of the dorsal spine [Figure 1b]. There were well‐defined bilateral symmetric “tuber‐like” (inset) neurofibromas involving the lumbar [Figure 1c and d] spine and paraspinal soft tissue. He had been advised surgery for the cranial most tumor causing his symptoms and cautioned to the need for further surgery later. He refused any surgery at the time. At 21 months follow‐up, there had been no neurological decline. This case highlights the importance of regular long‐term follow‐up in patients of multiple neurofibromas who can remain asymptomatic until well into adulthood.