Deep Vein Thrombosis in the Setting of Neurofibromatosis Type 1: Case Report

• Main Authors: Fernando Guedes, Francisco Torrão, Gabriel E. Sanches, Ana Caroline Siquara-de-Sousa, Arno von Ristow, Paulo Niemeyer Filho
• Format: Article
• Language: English
• Published: Thieme Revinter Publicações Ltda. 2021-01-01
• Series: Brazilian Neurosurgery
• Subjects: neurofibromatosis 1; neurofibroma; venous thrombosis
• Online Access: http://www.thieme-connect.de/DOI/DOI?10.1055/s-0040-1722244

Neurofibromatosis type 1 (NF1) is a genetic syndrome which typically presents with neurological manifestations. Some of the patients may also present with vasculopathies, among which arterial aneurysms and stenosis are the most common. Deep vein thrombosis (DVT) has rarely been described, and, to the best of our knowledge, the present is the first report of DVT due to venous compression by a neurofibroma in the setting of NF1. This is the case of a 23-year-old male with NF1 who experienced DVT due to compression of the left posterior tibial veins by a large tumor arising from the tibial nerve. The DVT was acutely treated with enoxaparin and then with rivaroxaban. Two months after the diagnosis, Doppler ultrasonography showed partial recanalization and persistence of the DVT. The patient was then referred to neurosurgery for surgical resection of the tumor. There were no complications during the procedure, and the patient did not present postoperative neurological deficits. The final histopathological diagnosis was of a benign neurofibroma. After one year of follow-up with vascular surgery, the patient presented no more episodes of DVT. In case there is a tumor compressing the deep vessels of the leg and promoting DVT, surgical resection with microsurgical techniques may be curative.