Hemosuccus pancreaticus from a splenic artery pseudoaneurysm as a rare cause of gastrointestinal bleeding: a case report.

Neurofibromatosis type 1 is an autosomal dominant tumor-predisposition disorder with cutaneous, neurologic, skeletal, and soft-tissue manifestations (–). Plexiform or diffuse neurofibromas may cause disfigurement, pain, functional impairment, and concern for malignant transformation. MEK-inhibitor therapy has expanded treatment options for selected inoperable plexiform neurofibromas, but surgery remains important for resectable, symptomatic, recurrent, or deforming lesions (, , –). Large NF1-associated tumors can be mistaken for vascular lesions when imaging shows prominent or disorganized vessels (). Surgery may be complicated by vascular fragility, prior scarring, recurrence, and the need to reconstruct a broad irregular defect (, , , ). Skin overlying a tumor has occasionally been reused to reduce donor-site morbidity, but its biological and oncologic suitability cannot be assumed when the lesion is infiltrative or involves the dermis and subcutaneous tissue (, ). Here, we describe a young woman with a recurrent giant neurofibroma of the posterior neck and upper back that was initially misdiagnosed as hemangioma. We focus on three clinically relevant issues: diagnostic pitfalls, blood-sparing resection along an appropriate anatomic plane, and salvage reconstruction after failure of tumor-surface recycled grafting.