{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,12]],"date-time":"2026-07-12T03:32:25Z","timestamp":1783827145146,"version":"3.55.0"},"reference-count":11,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2020,5,18]],"date-time":"2020-05-18T00:00:00Z","timestamp":1589760000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2020,5,18]],"date-time":"2020-05-18T00:00:00Z","timestamp":1589760000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["BMC Surg"],"abstract":"<jats:title>Abstract<\/jats:title><jats:sec>\n                <jats:title>Background<\/jats:title>\n                <jats:p>A large plexiform neurofibroma in patients with neurofibromatosis type I can be life threatening due to possible massive bleeding within the lesion. Although the literature includes many reports that describe the plexiform neurofibroma size and weight or strategies for their surgical treatment, few have discussed their possible physical or mental benefits, such as reducing cardiac stress. In addition, resection of these large tumors can result in impaired wound healing, partly due to massive blood loss during surgery.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Case presentation<\/jats:title>\n                <jats:p>A 24-year-old man was diagnosed with neurofibromatosis type I and burdened with a large plexiform neurofibroma on the buttocks and upper posterior thighs. The patient was 159 cm in height and 70.0 kg in weight at the first visit. Cardiac overload was indicated by an echocardiography before surgery. His cardiac output was 5.2 L\/min with mild tricuspid regurgitation. After embolism of the arteries feeding the tumor, the patient underwent surgery to remove the neurofibroma, followed by skin grafting. Follow-up echocardiography, performed 6 months after the final surgery, indicated a decreased cardiac output (3.6 L\/min) with improvement of tricuspid regurgitation. Because the blood loss during the first surgery was over 3.8 L, malnutrition with albuminemia was induced and half of the skin graft did not attach. Nutritional support to improve the albuminemia produced better results following a second surgery to repair the skin wound.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusion<\/jats:title>\n                <jats:p>Cardiac overload may be latent in patients with neurofibromatosis type I with large plexiform neurofibromas. As in pregnancy, the body may compensate for this burden. In these patients, one stage total excision may improve quality of life and reduce cardiac overload. In addition, nutritional support is likely needed following a major surgery that results in either an extensive skin wound or excessive blood loss during treatment.<\/jats:p>\n              <\/jats:sec>","DOI":"10.1186\/s12893-020-00761-4","type":"journal-article","created":{"date-parts":[[2020,5,18]],"date-time":"2020-05-18T17:04:17Z","timestamp":1589821457000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Cardiac overload resolved by resection of a large plexiform neurofibroma on both the buttocks and upper posterior thighs in a patient with neurofibromatosis type I: a case report"],"prefix":"10.1186","volume":"20","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1381-2070","authenticated-orcid":false,"given":"Taro","family":"Mikami","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yuki","family":"Honma-Koretsune","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yui","family":"Tsunoda","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shintaro","family":"Kagimoto","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yuichiro","family":"Yabuki","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jiro","family":"Maegawa","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Miki","family":"Terauchi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shintaro","family":"Nawata","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hiroyuki","family":"Kamide","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yoshinobu","family":"Ishiwata","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tabito","family":"Kino","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Teruyasu","family":"Sugano","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2020,5,18]]},"reference":[{"key":"761_CR1","first-page":"5245","volume":"8","author":"SM Yuan","year":"2015","unstructured":"Yuan SM, Cui L, Guo Y, Wang J, Hu XB, Jiang HQ, et al. Surgical management of giant neurofibroma in soft tissue: a single-center retrospective analysis. Int J Clin Exp Med. 2015;8:5245\u201353.","journal-title":"Int J Clin Exp Med"},{"key":"761_CR2","doi-asserted-by":"publisher","first-page":"456","DOI":"10.1016\/j.bjps.2004.02.015","volume":"57","author":"N White","year":"2004","unstructured":"White N, Gwanmesia I, Akhtar N, Withey SJ. Severe haemorrhage in neurofibromatoma: a lesson. Br J Plast Surg. 2004;57:456\u20137.","journal-title":"Br J Plast Surg"},{"key":"761_CR3","doi-asserted-by":"publisher","first-page":"e225","DOI":"10.1259\/bjr\/42783229","volume":"83","author":"RG Jones","year":"2010","unstructured":"Jones RG, Kiatisevi P, Morris DC, Munk PL, Clarkson PW, Masri BA. Intravascular embolisation and surgical resection of a giant neurofibroma with intratumoural haemorrhage. Br J Radiol. 2010;83:e225\u20139.","journal-title":"Br J Radiol"},{"key":"761_CR4","doi-asserted-by":"publisher","first-page":"678","DOI":"10.1016\/S0022-3476(97)70092-1","volume":"131","author":"MN Needle","year":"1997","unstructured":"Needle MN, Cnaan A, Dattilo J, Chatten J, Phillips PC, Shochat S, et al. Prognostic signs in the surgical management of plexiform neurofibroma: the Children's Hospital of Philadelphia experience, 1974-1994. J Pediatr. 1997;131:678\u201382.","journal-title":"J Pediatr"},{"key":"761_CR5","first-page":"987623","volume":"2013","author":"R Velez","year":"2013","unstructured":"Velez R, Barrera-Ochoa S, Barastegui D, Perez-Lafuente M, Romagosa C, Perez M. Multidisciplinary management of a giant plexiform neurofibroma by double sequential preoperative embolization and surgical resection. Case Rep Neurol Med. 2013;2013:987623.","journal-title":"Case Rep Neurol Med"},{"key":"761_CR6","doi-asserted-by":"publisher","first-page":"e514","DOI":"10.1097\/SCS.0b013e3182a23535","volume":"24","author":"KL Tomei","year":"2013","unstructured":"Tomei KL, Gupta V, Prestigiacomo CJ, Gandhi CD. Spontaneous hemorrhage of a facial neurofibroma: endovascular embolization before surgical intervention. J Craniofac Surg. 2013;24:e514\u20137.","journal-title":"J Craniofac Surg."},{"key":"761_CR7","doi-asserted-by":"publisher","first-page":"e405","DOI":"10.1097\/SCS.0000000000001873","volume":"26","author":"SM Yuan","year":"2015","unstructured":"Yuan SM, Guo Y, Cui L, Wang J, Hu XB, Zhou JH, et al. Surgical Management of Giant Scalp Neurofibroma after Ultra-Selective Embolization of nutrient artery. J Craniofac Surg. 2015;26:e405\u20137.","journal-title":"J Craniofac Surg"},{"key":"761_CR8","doi-asserted-by":"publisher","first-page":"442","DOI":"10.1097\/00000637-200045040-00017","volume":"45","author":"MY Nahabedian","year":"2000","unstructured":"Nahabedian MY, Rozen SM, Namnoum JD, Vander Kolk CA. Giant plexiform neurofibroma of the back. Ann Plast Surg. 2000;45:442\u20135.","journal-title":"Ann Plast Surg"},{"key":"761_CR9","unstructured":"F T, A MMA, L BAd, T CCC, R CL, G HTSB, et al. Giant malignant peripheral nerve sheath tumor of the scalp. Acta Neurol Taiwan. 2012;21:133-5."},{"key":"761_CR10","doi-asserted-by":"publisher","first-page":"754","DOI":"10.1016\/j.wneu.2010.09.030","volume":"75","author":"AL Ross","year":"2011","unstructured":"Ross AL, Panthaki Z, Levi AD. Surgical management of a giant plexiform neurofibroma of the lower extremity. World Neurosurg. 2011;75:754\u20137.","journal-title":"World Neurosurg"},{"key":"761_CR11","doi-asserted-by":"crossref","unstructured":"Dias IS, Pessoa SGdP, Macedo JE, Cavalcante DJ, Alencar JCGd. Surgical correction of a giant neurofibroma. Rev Bras Cir Pl\u00e1st 2012;27:336-339.","DOI":"10.1590\/S1983-51752012000200029"}],"updated-by":[{"DOI":"10.1186\/s12893-024-02591-0","type":"correction","label":"Correction","source":"publisher","updated":{"date-parts":[[2024,10,26]],"date-time":"2024-10-26T00:00:00Z","timestamp":1729900800000}}],"container-title":["BMC Surgery"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12893-020-00761-4.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1186\/s12893-020-00761-4\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12893-020-00761-4.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,10,28]],"date-time":"2024-10-28T08:45:35Z","timestamp":1730105135000},"score":1,"resource":{"primary":{"URL":"https:\/\/bmcsurg.biomedcentral.com\/articles\/10.1186\/s12893-020-00761-4"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,5,18]]},"references-count":11,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2020,12]]}},"alternative-id":["761"],"URL":"https:\/\/doi.org\/10.1186\/s12893-020-00761-4","relation":{"correction":[{"id-type":"doi","id":"10.1186\/s12893-024-02591-0","asserted-by":"object"}]},"ISSN":["1471-2482"],"issn-type":[{"value":"1471-2482","type":"electronic"}],"subject":[],"published":{"date-parts":[[2020,5,18]]},"assertion":[{"value":"11 October 2019","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"28 April 2020","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"18 May 2020","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"26 October 2024","order":4,"name":"change_date","label":"Change Date","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"Correction","order":5,"name":"change_type","label":"Change Type","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"A Correction to this paper has been published:","order":6,"name":"change_details","label":"Change Details","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"https:\/\/doi.org\/10.1186\/s12893-024-02591-0","URL":"https:\/\/doi.org\/10.1186\/s12893-024-02591-0","order":7,"name":"change_details","label":"Change Details","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"All procedures carried out on this patient complied with the Helsinki Declaration. The ethics committee at Yokohama City University Hospital has approved the case report to be submitted.","order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"Written informed consent was obtained from the patient for publication of this report and accompanying images.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"The authors declare that they have no competing interests.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"106"}}