"This case underscores the importance of meticulous surgical technique, the potential value of IONM, and vigilant postoperative care in achieving optimal outcomes for deep-seated pediatric neurofibromas."
BUFFALO, NY — January 21, 2026 — A new case report was published in Volume 12 of Oncoscience on December 23, 2025, titled " Solitary diffuse-type giant neurofibroma arising from the sciatic nerve in a 13-year-old: A rare occurrence ."
In this report by Reshmi Sultana from the All India Institute of Medical Sciences, Bibinagar, and Suryadevara Sailaja from Alluri Sitaram Raju Academy of Medical Sciences , it is described a rare diagnosis and successful surgical treatment of a giant solitary neurofibroma in a 13-year-old boy. The tumor, which caused no pain or disability, was discovered by accident and removed through a complex, nerve-sparing procedure. This case highlights the diagnostic and surgical challenges of rare pediatric nerve covering tumors.
Neurofibromas are benign tumors that grow from the protective lining of nerves. They are often linked to a genetic disorder called neurofibromatosis. However, this case involved a solitary tumor with no connection to that condition. What made the case particularly unusual was the tumor's location deep within the thigh, along the sciatic nerve, a rare site for such growths in children. Because of their slow growth and deep placement, these tumors can go unnoticed for long periods. In this case, the child discovered a painless swelling in his thigh while playing.
"MRI revealed a 12.8 × 6.6 × 3.8 cm lobulated intermuscular mass along the sciatic nerve. Tru-cut biopsy suggested a cellular neurofibroma."
Imaging tests revealed a 13-centimeter mass growing between muscles and surrounding the sciatic nerve, but without affecting nearby bones. A biopsy confirmed it was a cellular neurofibroma. Despite not having access to real-time nerve monitoring equipment during surgery, the team was able to carefully separate the tumor from the nerve using magnification and microsurgical techniques. This approach helped protect the nerve fibers and maintain function. After the operation, the child experienced temporary foot drop, a condition that affects the ability to lift the foot, but made a full recovery with physiotherapy.
Laboratory analysis of the tumor confirmed it was a benign, diffuse-type neurofibroma. It tested positive for certain neural markers and showed a low rate of cell growth, supporting its non-cancerous nature. These features helped distinguish it from more aggressive tumors that can mimic neurofibromas.
While most soft tissue tumors in children are small and located closer to the skin, this case shows how larger, deep-seated tumors can remain hidden and only come to attention once they grow significantly. The report underscores the importance of early diagnosis and careful surgical planning, especially when tumors are located near major nerves.
This case adds important knowledge to the limited medical literature on deep neurofibromas in children and demonstrates that high-risk tumors can be effectively treated with favorable long-term results.
DOI: https://doi.org/10.18632/oncoscience.640
