Plexiform Neurofibroma
Plexiform neurofibroma is the most common benign peripheral nerve tumor and is most commonly associated with Neurofibromatosis type 1, an inherited multisystem neurocutaneous disorder resulting from mutations in the NF1 gene. Eyelid tumors typically occur along the peripheral branches of the trigeminal nerve and can assume a massive size with significant visual compromise. They may have extensive infiltration into the levator muscle and its aponeurosis with impairment of levator function and ptosis. Surgery may be indicated for cosmesis or for prevention of amblyopia from visual obstruction. Because of the infiltrative nature of the tumor and the lack of a circumscribed capsule, complete surgical debulking is impossible and repeated sessions of surgical debulking are usually required.