Large vascular plexiform neurofibroma of scalp: excision and coverage with free tissue transfer

Diffuse neurofibroma (paraneurofibroma) is an unusual variant of neurofibroma in which the tumor cells diffusely infiltrate beyond the usual well-circumscribed boundary. Histological features of the tumor include both typical and plexiform neurofibroma. Although benign, diffuse vascularity with the possibility of life-threatening hemorrhage dictates treatment. The combination of preoperative angiography, wide surgical excision, and resurfacing the defect with well-vascularized tissue offers one-stage reconstruction and possible cure.