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Oncol."],"abstract":"<jats:p>Lateral thoracic meningocele is a rare clinical entity typically associated with neurofibromatosis type 1 (NF1), which can progressively enlarge under the cerebrospinal fluid (CSF) pressure. Despite its rarity, these lesions may rupture or be associated with intracranial hypotension syndrome (IHS). We herein describe a 50-year-old woman presenting with a 2-year history of dyspnea, positional headaches, and dizziness. Imaging revealed a giant lateral thoracic meningocele with right-sided pleural effusion. Following thoracentesis with evacuation of 480 ml effusion (later confirmed as CSF), her headache intensified markedly; subsequent brain MRI demonstrated characteristic features of IHS. Surgical excision of the meningocele was performed, and the patient experienced a favorable recovery, with discharge on postoperative day 22. This case underscores critical clinical insights: NF1-associated giant lateral thoracic meningoceles may manifest respiratory symptoms alongside severe complications, including rupture and IHS. Crucially, procedures such as thoracentesis require extreme caution, as they risk exacerbating CSF leakage and may precipitate life-threatening cerebellar tonsillar herniation.<\/jats:p>","DOI":"10.3389\/fonc.2025.1662107","type":"journal-article","created":{"date-parts":[[2025,11,21]],"date-time":"2025-11-21T05:14:48Z","timestamp":1763702088000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":1,"title":["Ruptured giant lateral thoracic meningocele associated with intracranial hypotension syndrome in neurofibromatosis type 1: case report with long-term follow-up"],"prefix":"10.3389","volume":"15","author":[{"given":"Wenfu","family":"Li","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hui","family":"Zhou","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1965","published-online":{"date-parts":[[2025,11,21]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","DOI":"10.1158\/2159-8290.Cd-18-0151","article-title":"Spatiotemporal loss of NF1 in schwann cell lineage leads to different types of cutaneous neurofibroma susceptible to modification by the hippo pathway","volume":"9","author":"Chen","year":"2019","journal-title":"Cancer Discov"},{"key":"B2","doi-asserted-by":"publisher","DOI":"10.1148\/rg.210235","article-title":"Neurofibromatosis from head to toe: what the radiologist needs to know","volume":"42","author":"Wang","year":"2022","journal-title":"Radiographics"},{"key":"B3","doi-asserted-by":"publisher","DOI":"10.1016\/j.bone.2008.10.050","article-title":"Congenital pseudarthrosis of neurofibromatosis type 1: impaired osteoblast differentiation and function and altered NF1 gene expression","volume":"44","author":"Leskel\u00e4","year":"2009","journal-title":"Bone"},{"key":"B4","doi-asserted-by":"publisher","DOI":"10.1097\/NRL.0b013e3182173540","article-title":"A neurofibromatosis type 1 patient with thoracic encapsulated fluid and intracranial hypotension syndrome: a case report","volume":"17","author":"Huang","year":"2011","journal-title":"Neurologist"},{"key":"B5","doi-asserted-by":"publisher","DOI":"10.1007\/s00234-024-03381-4","article-title":"Unruptured giant lateral thoracic meningocele: extremely rare cause of cerebrospinal fluid (CSF) hypotension in neurofibromatosis type 1","volume":"66","author":"Krishnan","year":"2024","journal-title":"Neuroradiology"},{"key":"B6","first-page":"1","article-title":"Neurofibromatosis","volume":"6","year":"1987","journal-title":"Natl Inst Health Consens Dev Conf Consens Statement"},{"key":"B7","doi-asserted-by":"publisher","first-page":"17004","DOI":"10.1038\/nrdp.2017.4","article-title":"Neurofibromatosis type 1","volume":"3","author":"Gutmann","year":"2017","journal-title":"Nat Rev Dis Primers"},{"key":"B8","doi-asserted-by":"publisher","DOI":"10.1038\/s41436-021-01170-5","article-title":"Revised diagnostic criteria for neurofibromatosis type 1 and Legius syndrome: an international consensus recommendation","volume":"23","author":"Legius","year":"2021","journal-title":"Genet Med"},{"key":"B9","doi-asserted-by":"publisher","first-page":"E7","DOI":"10.3171\/2022.2.Focus21790","article-title":"Management and surgical outcomes of dystrophic scoliosis in neurofibromatosis type 1: a systematic review","volume":"52","author":"Neifert","year":"2022","journal-title":"Neurosurg Focus"},{"key":"B10","doi-asserted-by":"publisher","DOI":"10.1007\/s00381-020-04754-9","article-title":"Spinal manifestations of Neurofibromatosis type 1","volume":"36","author":"Shofty","year":"2020","journal-title":"Childs Nerv Syst"},{"key":"B11","doi-asserted-by":"publisher","DOI":"10.3171\/2017.2.Spine16699","article-title":"Intrathoracic meningocele associated with neurofibromatosis Type 1 and a novel technique for surgical repair: case report","volume":"27","author":"Das","year":"2017","journal-title":"J Neurosurg Spine"},{"key":"B12","doi-asserted-by":"publisher","DOI":"10.1007\/s00330-013-2941-8","article-title":"Spinal bone defects in neurofibromatosis type I with dural ectasia: stress fractures or dysplastic? 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