Neurofibromas of saphenous nerve mimicking thrombophlebitis

Young man aged 25 years complained of persistent pain on the medial side of the lower part of the thigh for 2 months. A cord like structure was palpable with 3 small nodular swelling parallel to the course of the long saphenous vein. Initially he was treated as a case of thrombophlebitis of saphenous vein in a clinic near his home. When the pain persisted after receiving injection heparin therapy, he was referred to the vascular surgery clinic. Duplex scan reported as thrombophlebitis of a vein parallel to the great saphenous vein. We continued the injection heparin and suspected thrombophilia. There were no other known risk factors for thrombosis. The pain persisted, so we excised the cord like structure with nodular swellings and biopsy reported it as neurofibromatosis of the saphenous nerve. Postoperatively the pain subsided dramatically and in the follow up clinic he mentioned about the paresthesias in the distribution area of saphenous nerve. Diagnosis of the small tumors of the peripheral nerves is difficult at this site and they can be easily mistaken for thrombophlebitis. Unusual pain and nodularity of the swelling as in this case can help us to consider early biopsy or excision of the tumor.