Atypical presentation with malignant transformation in neurofibromatosis Type 1 and strategies for managing neuropathic pain

Pain is considered as a vital parameter for any patient management. Type I neurofibromatosis (NF-1) is an autosomal dominant neurocutaneous disorder caused by loss-of-function mutations in the NF-1 gene. The presence of severe pain is an atypical feature of NF-1, and the possibility of malignant tra...

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Main Authors: Deepti Ahuja, Rakesh Garg
Format: Article
Language:English
Published: Wolters Kluwer Medknow Publications 2019-01-01
Series:Indian Journal of Pain
Subjects:
Online Access:http://www.indianjpain.org/article.asp?issn=0970-5333;year=2019;volume=33;issue=3;spage=161;epage=163;aulast=Ahuja
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author Deepti Ahuja
Rakesh Garg
author_facet Deepti Ahuja
Rakesh Garg
author_sort Deepti Ahuja
collection DOAJ
description Pain is considered as a vital parameter for any patient management. Type I neurofibromatosis (NF-1) is an autosomal dominant neurocutaneous disorder caused by loss-of-function mutations in the NF-1 gene. The presence of severe pain is an atypical feature of NF-1, and the possibility of malignant transformation with the development of a malignant peripheral nerve sheath tumor (MPNST) should be considered in such situation. These tumors are universally foreshadowed by the onset of severe pain. The present treatment options that can be used in the management of these patients have not been well described in the available literature. We report a case of NF-1 with atypical pain, its malignant transformation, and its management. This case report is unique as it attempts to correlate the mechanism and target therapeutic options in the management of pain in patients of NF with MPNST. We conclude by emphasizing that various available options for management of pain should be employed after understanding the pathophysiology behind the occurrence of pain in a clinical setting. Treatment of malignancy and management of pain should be done simultaneously.
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spelling doaj.art-dc4a2b9c112c4b72acdb91e266ab5a1c2022-12-22T01:34:37ZengWolters Kluwer Medknow PublicationsIndian Journal of Pain0970-53332019-01-0133316116310.4103/ijpn.ijpn_26_19Atypical presentation with malignant transformation in neurofibromatosis Type 1 and strategies for managing neuropathic painDeepti AhujaRakesh GargPain is considered as a vital parameter for any patient management. Type I neurofibromatosis (NF-1) is an autosomal dominant neurocutaneous disorder caused by loss-of-function mutations in the NF-1 gene. The presence of severe pain is an atypical feature of NF-1, and the possibility of malignant transformation with the development of a malignant peripheral nerve sheath tumor (MPNST) should be considered in such situation. These tumors are universally foreshadowed by the onset of severe pain. The present treatment options that can be used in the management of these patients have not been well described in the available literature. We report a case of NF-1 with atypical pain, its malignant transformation, and its management. This case report is unique as it attempts to correlate the mechanism and target therapeutic options in the management of pain in patients of NF with MPNST. We conclude by emphasizing that various available options for management of pain should be employed after understanding the pathophysiology behind the occurrence of pain in a clinical setting. Treatment of malignancy and management of pain should be done simultaneously.http://www.indianjpain.org/article.asp?issn=0970-5333;year=2019;volume=33;issue=3;spage=161;epage=163;aulast=Ahujaatypicalmalignancymalignant peripheral nerve sheath tumorneurofibromatosispain
spellingShingle Deepti Ahuja
Rakesh Garg
Atypical presentation with malignant transformation in neurofibromatosis Type 1 and strategies for managing neuropathic pain
Indian Journal of Pain
atypical
malignancy
malignant peripheral nerve sheath tumor
neurofibromatosis
pain
title Atypical presentation with malignant transformation in neurofibromatosis Type 1 and strategies for managing neuropathic pain
title_full Atypical presentation with malignant transformation in neurofibromatosis Type 1 and strategies for managing neuropathic pain
title_fullStr Atypical presentation with malignant transformation in neurofibromatosis Type 1 and strategies for managing neuropathic pain
title_full_unstemmed Atypical presentation with malignant transformation in neurofibromatosis Type 1 and strategies for managing neuropathic pain
title_short Atypical presentation with malignant transformation in neurofibromatosis Type 1 and strategies for managing neuropathic pain
title_sort atypical presentation with malignant transformation in neurofibromatosis type 1 and strategies for managing neuropathic pain
topic atypical
malignancy
malignant peripheral nerve sheath tumor
neurofibromatosis
pain
url http://www.indianjpain.org/article.asp?issn=0970-5333;year=2019;volume=33;issue=3;spage=161;epage=163;aulast=Ahuja
work_keys_str_mv AT deeptiahuja atypicalpresentationwithmalignanttransformationinneurofibromatosistype1andstrategiesformanagingneuropathicpain
AT rakeshgarg atypicalpresentationwithmalignanttransformationinneurofibromatosistype1andstrategiesformanagingneuropathicpain