J Korean Neurosurg Soc.  2025 May;68(3):261-271. 10.3340/jkns.2025.0057.

Lifelong Management of Neurofibromatosis 1 Patients

Affiliations
  • 1Department of Neurosurgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea

Abstract

Neurofibromatosis type 1 (NF1) is a prevalent genetic disorder characterized by a wide spectrum of clinical manifestations, including cutaneous, neurological, and oncological complications. The disease results from mutations in the NF1 gene, which encodes neurofibromin, a tumor suppressor that regulates the RAS/mitogen-activated protein kinase (MAPK) pathway. The loss of neurofibromin function predisposes individuals to both benign and malignant neoplasms, including malignant peripheral nerve sheath tumors, optic pathway gliomas, and gastrointestinal stromal tumors. Additionally, women with NF1 are at a significantly increased risk of developing breast cancer at a younger age, necessitating enhanced surveillance measures. Beyond oncological risks, NF1 is frequently associated with cognitive and behavioral impairments, including learning disabilities, attention-deficit hyperactivity disorder, and social communication difficulties, which significantly impact academic, occupational, and social outcomes. Moreover, systemic complications such as skeletal deformities, cardiovascular abnormalities, and chronic pain further contribute to the disease burden. Given the progressive and lifelong nature of NF1, comprehensive care strategies incorporating multidisciplinary management, early detection, and targeted interventions are essential to optimizing patient outcomes. This review highlights the importance of an integrative, lifelong management approach that addresses both the medical and psychosocial aspects of NF1. By implementing tailored surveillance programs and evidence-based interventions, healthcare providers can improve quality of life and reduce morbidity and mortality associated with this complex disorder.

Keyword

Neurofibromatosis 1; Neoplasms; Cognitive dysfunction; Early detection of cancer; Quality of life
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