Could an osteoinductor result in degeneration of a neurofibroma in NF1?

Eur Spine J. 2010 Jul;19 Suppl 2(Suppl 2):S220-5. doi: 10.1007/s00586-010-1416-8. Epub 2010 May 7.

Abstract

We report a case of fatal evolution of neurofibromatosis in a young boy. A laminectomy was performed when he was 9 years old. A secondary hyperkyphosis led to many surgeries resulting in recurrent malunions. When he was 23 years old, a breakage of his rods was treated by a new instrumentation and a T12-L1 interbody cage fitted with rh-BMP. Five months later, he developed a huge posterior tumour on his back. The biopsy diagnosed a neurofibrosarcoma. The growth of the tumour was extremely rapid. He died after several months from a septic shock. NF1 is characterised by neurofibromas that have a possibility of malign degeneration and conversion to a sarcoma. However, the chronology, rapidity of evolution and the exceptional volume of the tumour made us wonder whether the BMP had a part of responsibility as osteoinductor in the malignant degeneration, in this particular case, of neurofibromatosis. It seemed important to point out this case to the medical community.

Publication types

  • Case Reports

MeSH terms

  • Bone Morphogenetic Proteins / adverse effects*
  • Disease Progression
  • Fatal Outcome
  • Humans
  • Male
  • Neurofibroma / pathology
  • Neurofibroma / surgery
  • Neurofibromatosis 1 / pathology
  • Neurofibromatosis 1 / surgery
  • Neurofibrosarcoma / chemically induced*
  • Neurofibrosarcoma / pathology*
  • Neurofibrosarcoma / physiopathology
  • Postoperative Complications / drug therapy*
  • Spinal Neoplasms / chemically induced*
  • Spinal Neoplasms / pathology*
  • Spinal Neoplasms / physiopathology
  • Young Adult

Substances

  • Bone Morphogenetic Proteins