Research Article

Nonoperative Management May Be a Viable Approach to Plexiform Neurofibroma of the Porta Hepatis in Patients with Neurofibromatosis-1

Table 1

Summary of case reports of management of PNF involving Porta Hepatis in adults.

S. numberAuthorYearAge (Y)GenderNF-1Clinical presentationMRI/CT if MRI not available Treatment approach PathFollow-up

(1)Lee et al. 201649MYesAsymptomatic, incidental findings of portal hypertension on EGD and USHypointense T1 lesion and low attenuating mass-like lesion with weak enhancement on T2 imagesMedical management with beta-blockers for portal hypertension. Mass thought to be unresectable due to extension into hepatic hilum and lesser omentum - -

(2)Poon et al.200840MNo4-5-year history of intermittent upper abdominal pain with nausea and vomitingT1 hypointense and in homogenously T2 hyperintenseTumor resected en-blocNeurofibroma1 year

(3)Ghalib et al.199530FYesIntermittent right upper quadrant painLow attenuating mass encasing the left portal vein, extending into the liver, extending into the gastrohepatic ligament, encasement of hepatic artery up to celiac axisExploratory laparotomy. Mass found to be unresectablePlexiform neurofibroma -

(4) Rastogi200835MYes6-month history of vague abdominal painMultiple hypoattenuating masses in the liver, porta hepatis, peripancreatic region and retroperitoneumNonsurgical management -4 months

(5)Malagari et al. 200124MYesAsymptomatic, incidentally found on US7 cm well defined lesion in left hepatic lobe extending into porta hepatis and encasing the hepatic artery and celiac trunkExploratory laparotomy. Mass found to be unresectablePlexiform neurofibroma -

(6)Hoshimoto et al.200924FYesIntermittent abdominal painT2 hyperintense tumor involving hepatoduodenal ligament and hepatic hilum, extending along intrahepatic Glisson’s sheathThe tumor was resected, leaving behind the intrahepatic extensionPlexiform neurofibroma3 years

(7)Ji et al.201754MNo3-month history of abdominal pain and weight loss of 3 months3.6 × 1.7 cm homogenous low-attenuation mass at the porta hepatis with irregular infiltrative margins, encasing and spreading along hepatic arteryTumor resected; tumor was gradually peeled off from the hepatic artery along the arterial sheathPlexiform neurofibroma18 months

(8)Gallego et al.199850M UnknownUnknown symptoms. Isolated neurofibromas in the liver, mediastinum, celiac axis and mesenteryAnomalous mesenteric and retroperitoneal tissue extending through hepatoduodenal ligament in to interhepatic periportal spaces. T1 hypointense and T2 hyperintenseNonsurgical managementPlexiform neurofibroma2 years

(9)Rodríguez et al.199324MYesVague abdominal complaintsT1 hypointense and T2 hyperintense. Well defined mass around the porta hepatis and its peripheral branches.Nonsurgical management5 months

(10)Chen et al.199118MYesPresented with PNF of the skull. Liver PNF incidentalRetroperitoneal neurofibroma with extension into the liver along the portal veinNonsurgical management -3 months