11. Dermal neurofibroma typically arise in the teenage years and are often associated with the onset of puberty. 12. A blood test for protein melanoma inhibitory activity may be used to detect the presence of neurofibromas . 13. Treating patients with extensive neurofibromas with [ a ] CO 2 laser is still the best choice. 14. However, besides pain, plexiform neurofibromas are sometimes removed due to the possibility of malignant transformation. 15. Once a plexiform neurofibroma has undergone malignant transformation, radiation and chemotherapy can be used as treatment. 16. About 10 % of plexiform neurofibromas undergo transformation into a malignant peripheral nerve sheath tumor ( MPNST ). 17. There has even been a documented case of a Schwannoma being induced from a neurofibroma due to radiation therapy. 18. Plexiform neurofibromas can grow from nerves in the skin or from more internal nerve bundles, and can be very large. 19. In a paper titled " Hypertrophic Scars After Therapy with CO 2 Laser for Treatment of Multiple Cutaneous Neurofibromas " 20. In order for the neurofibroma to develop, cells that are heterozygous for the NF1 gene must be recruited to the site.
