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Course: Long History of Multiple Painless Scalp Nodules in a Middle-aged Woman

CME Credits: 1.00

Released: 2023-03-01

A woman in her late 40s was admitted to the hospital with a 40-year history of multiple hard nodules on the scalp. At 5 years of age, the patient had developed multiple subcutaneous masses in the occipital and bilateral temporal regions. At age 10, she was diagnosed with neurofibromatosis and underwent surgical resection of the tumors at a local hospital. Tumors recurred 5 years after surgery, with their size and number gradually increasing with age. Physical examination revealed scalp masses from 4 to 6 cm in diameter, with hard textures and smooth surfaces (, A), and subcutaneous nodules of 1?×-1 cm to 2?×-2 cm with hard textures on the hands (, B), feet, trunk, and lower extremities. The patient had no tenderness, swelling, or other skin manifestations. The patient had consanguineous parents, but no other family member, including her children, had the disease.


Educational Objective
Based on this clinical scenario and the accompanying image, understand how to arrive at a correct diagnosis.


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