JMCR: Clinical Minute

Adult-onset multifocal retroperitoneal plexiform neurofibromas: a case report Jahromi M, Safari F, Nabavi A, Afrakhteh H. Adult-onset multifocal retroperitoneal plexiform neurofibromas: a case report. Journal of Medical Case Reports. Accepted June 29, 2026. DOI: 10.1186/s13256-026-06324-0.
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Main Article Highlights

  • Rare presentation: Adult-onset, multifocal, discrete retroperitoneal plexiform neurofibromas without an established diagnosis of neurofibromatosis type 1 (NF1).
  • Clinical presentation: A 37-year-old woman presented with 3 months of intermittent abdominal pain and bilateral hydronephrosis; longstanding iron-deficiency anemia was considered an incidental comorbidity.
  • Imaging findings: CT demonstrated multiple well-defined bilateral paraspinal and psoas soft-tissue masses compressing both ureters. MRI showed T1 isointense, T2 hyperintense, contrast-enhancing lesions, strongly favoring plexiform neurofibromas.
  • Diagnostic challenge: Histopathologic confirmation and genetic testing were not obtained because the patient was lost to follow-up; therefore, the diagnosis is radiologically favored rather than pathologically confirmed.
  • Clinical significance: This case expands the recognized phenotypic spectrum of plexiform neurofibromas and emphasizes the importance of multimodality imaging when evaluating unusual retroperitoneal masses.