Arch Hand Microsurg.  2025 Mar;30(1):74-79. 10.12790/ahm.24.0067.

Bilateral superficial circumflex iliac artery perforator free flap reconstruction for a large elbow neurofibroma: a case report

• Lee S
• Eun S

• KMID: 2565471
• DOI: http://doi.org/10.12790/ahm.24.0067

Abstract

Neurofibromas are benign neoplasms originating from neural tissues that rarely transform into malignancies. Approximately 25% to 45% of neurofibromas are located in the head and neck; the most common sites are the lateral cervical region and mouth. A 27-year-old female patient visited our hospital complaining of a painful brownish mass in the right elbow that had recently increased in size. She had no history of cancer and was otherwise in excellent health. This mass accounted for 80% of the total elbow circumference. Genetic mutation testing resulted in a diagnosis of neurofibromatosis type 1. A wide surgical excision was performed, and the area was repaired using a bilateral large superficial circumflex iliac artery perforator free flap. The flap survived well, with no partial necrosis. Histological findings showed a plexiform neurofibroma measuring 14×12×1.5 cm3. The patient’s postoperative course was uneventful; at an 18-month follow-up, she had good cosmetic and functional outcomes with no signs of relapse.

Keyword

Free tissue flaps; Elbow; Neurofibroma

Figure

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  Fig. 1. A 27-year-old female patient with a large brownish neurofibroma on her right elbow area.

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  Fig. 2. Recipient pedicle preparation of the posterior radial collateral artery (distal part) (A) and radial artery recurrent branch with venae comitantes (B).

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  Fig. 3. (A, B) Photographs of the bilateral superficial circumflex iliac artery perforator flap design. (C, D) The bilateral superficial circumflex iliac artery perforator flap is elvated. (E, F) The bilateral superficial circumflex iliac artery perforator flap is harvested after pedicle dissection.

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  Fig. 4. Microanastomoses between recipient vessels and flap pedicles. (A) Right posterior radial collateral artery (distal part) and (B) radial artery recurrent branch with venae comitantes.

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  Fig. 5. (A, B) Immediate postoperative photographs of the elbow with bilateral superficial circumflex iliac artery perforator flap. (C) Immediate postoperative photograph of the donor site with primary closure.

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  Fig. 6. An excised mass (A) and pathologic specimen (×40) of hematoxylin and eosin staining that shows numerous nerve bundles (B).

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  Fig. 7. Postoperative images at 6 months (A) and 18 months (B) of follow-up.

Reference

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