Defying Recurrence: Pioneering a Dual-Stage Surgical Solution for Recurrent Scalp Neurofibromas: A Rare Case Report

Area of Science:

• Neurosurgery
• Oncology
• Plastic Surgery

Background:

• Scalp neurofibromas are rare in neurofibromatosis type 1 (NF1).
• Recurrence is common after surgical excision due to location and incomplete removal.
• Managing recurrent scalp tumors presents significant challenges.

Purpose of the Study:

• To present an innovative two-stage surgical approach for recurrent scalp neurofibroma in an NF1 patient.
• To evaluate the efficacy and outcomes of this novel management strategy.
• To highlight the importance of advanced reconstructive techniques in complex cases.

Main Methods:

• A 48-year-old male with NF1 underwent a two-stage surgical procedure for a recurrent scalp neurofibroma.
• Stage 1: Complete tumor excision from the subgaleal plane and negative pressure wound therapy.
• Stage 2: Free flap reconstruction (rectus femoris/vastus lateralis) and split-thickness skin grafting.

Main Results:

• Histopathology confirmed spindle cell neurofibroma.
• One-year follow-up showed no tumor recurrence.
• Satisfactory esthetic outcomes were achieved post-reconstruction.
• The two-stage approach proved effective in managing this complex case.

Conclusions:

• A carefully planned two-stage surgical approach is effective for recurrent scalp neurofibromas in NF1.
• Aggressive excision combined with advanced reconstructive techniques yields successful outcomes.
• Multidisciplinary collaboration is vital for optimal management of NF1-related tumors.