Postoperative pathology confirmed perianal plexiform neurofibroma: a case report

Plexiform neurofibroma (PN) is extremely rare in the perianal region, primarily attributed to the lack of thick nerve trunks in the perianal area, and is closely related to neurofibromatosis type 1 (NF1).

Here we described a 21-year-old man who was admitted to the hospital with a chief complaint of a painless mass on the left perianal area for 10 years. Physical examination revealed a nodular cystic-solid mass approximately 6.0 cm × 3.0 cm in size in the left perianal area, with an irregular shape, soft texture, good mobility, and no obvious tenderness; no abnormalities were found during rectal examination. Preoperative pelvic magnetic resonance imaging revealed a 55 × 27 mm soft tissue lesion in the left ischial region, with radiological characteristics typical of nerve-derived tumors. The patient underwent complete surgical resection of the tumor, and postoperative histopathological analysis confirmed the diagnosis of PN without malignancy.

Complete surgical resection was the cornerstone, and histopathological confirmation was crucial. Long-term surveillance should be regarded as a means to prevent tumor recurrence or metastasis.