[Illustration: FIG. 87.--Plexiform Neuroma of small Sciatic Nerve, from
a girl aet. 16.
(Mr. Annandale's case.)]
There are other types of neuro-fibromatosis which require brief mention.
_The plexiform neuroma_ (Fig. 87) is a fibromatosis confined to the
distribution of one or more contiguous nerves or of a plexus of nerves,
and it may occur either by itself or along with multiple tumours of the
nerve-trunks and with pigmentation of the skin. The clinical features
are those of an ill-defined swelling composed of a number of tortuous,
convoluted cords, lying in a loose areolar tissue and freely movable on
one another. It is rarely the seat of pain or tenderness. It most often
appears in the early years of life, sometimes in relation to a pigmented
or hairy mole. It is of slow growth, may remain stationary for long
periods, and has little or no tendency to become malignant. It is
usually subcutaneous, and is frequently situated on the head or neck in
the distribution of the trigeminal or superficial cervical nerves. There
is no necessity for its removal, but this may be indicated because of
disfigurement, especially on the face or scalp or because its bulk
interferes with function. When involving the ophthalmic division of the
trigeminus, for example, it may cause enlargement of the upper lid and
proptosis, with danger to the function of the globe. The results of
excision are usually satisfactory, even if the removal is not complete.
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