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    Good morning Doctor, I'm 34 male from Mahboobnagar, Telangana. I

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Posted on Sat, 5 Aug 2017 in Brain and Spine
Question: Good morning Doctor,
I'm 34 male from Mahboobnagar, Telangana. I have two nodules pea sized on wrist and elbow one of which is there from my childhood. I observed a similar nodule on my abdomen for more than 5 years at least. Recently it's count increased to 3 or 4 near the abdomen but the size is same. All the above nodules are just below the skin and physically not visible except by touch. I consulted a Neurophysician who told it to be neurofiromatosis. But the doctor refused to talk much at it.
I'm having a daughter 7 years old. I'm planning to father my 2nd child. My doubt is whether it can pass to my child?. Presently I don't have any complications with this but if it is passed to offspring's what kind of complications can occur?
Thank you.

Also sir,
My younger sister was diagnosed with lipoma when she consulted a dermatologist which made me to doubt whether mine is also a lipoma or neuro fibrous. My nodules are all just below the skin. So can you also please tell how to differentiate between the two.
Thank you.
doctor
Answered by Dr. Sudhir Kumar 9 hours later
Brief Answer:
Both are usually harmless and do not cause complications.

Detailed Answer:
Thank you for posting your query.

I am Dr Sudhir Kumar, Neurologist, and I would try my best to help you.

I have noted your clinical details. Based on this, I agree we need to consider two possibilities- lipoma as well as neurofibroma. The best method to confirm the diagnosis is by doing a biopsy of one of the swellings (a general surgeon can remove it and send it for pathological examination).

If the biopsy report comes as neurofibroma, then, we need to determine whether is neurofibromatosis (NF) type I or II. Whether it can be transmitted to the child or not, can be answered by genetic testing. Genetic testing on blood sample can be done to confirm NF type I or II.

I hope my answer helps. Please get back if you have any follow up queries or if you require any additional information.

Wishing you good health,

Dr Sudhir Kumar MD (Internal Medicine), DM (Neurology) XXXXXXX Consultant Neurologist
Apollo Hospitals, XXXXXXX XXXXXXX
Click on this link to ask me a DIRECT QUERY: http://bit.ly/Dr-Sudhir-kumar
My BLOG: http://bestneurodoctor.blogspot.in


Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Sudhir Kumar 21 minutes later
Thank you for the Answer. Sir I'm looking forward to get biopsy done so that the risk of assessing transfer to child be made. Please clarify my following doubts.
1. If it is NF then my daughter does not have that means this started with me after her birth?
2. As per the information on net can this turn into malignancy in future?
3. Where can I get these genetic testing done in XXXXXXX
4. Does surgery is required for biopsy or simple needle test is sufficient?
Thank you
doctor
Answered by Dr. Sudhir Kumar 8 hours later
Brief Answer:
Genetic testing can be done at CDFD

Detailed Answer:
Thank you for getting back.

1. In NF, the disease can remain latent for several years and manifest later on. So, even if your symptoms came after after birth of your daughter, it is possible that the disease was latent. Genetic testing can confirm or exclude that.
2. The risk of malignancy is rare; and occurs in less than 1% of patients.
3. Genetic testing can be done at CDFD, located in NIMS Punjagutta campus.
4. Biopsy is more conclusive than the needle test.

Best wishes,

Dr Sudhir Kumar MD DM (Neurology)
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Sudhir Kumar 56 minutes later
Thank you sir,
One last question.
1.Does Biopsy comes under Inpatient procedure or out patient procedure. If inpatient then how much time should I need to stay in the hospital.
2. Can a needle test differentiate between lipoma and NF?
3. There are no swellings on my skin and visibly there is no difference in skin. So does incision is required for biopsy?
Thank you for taking your time in resolving my queries sir.
doctor
Answered by Dr. Sudhir Kumar 3 minutes later
Brief Answer:
These questions can be better addressed to a general surgeon

Detailed Answer:
Thank you for getting back with three more queries, which are not in my expertise area. They should be addressed to a general surgeon.

However, some general information can be given by me.

1. It is a minor procedure and can be done on OP basis. It can be completed in less than one hour, usually 30 minutes.
2. Needle test is less accurate than biopsy.
3. For biopsy, incision is required.

Best wishes,

Dr Sudhir Kumar MD DM (Neurology)


Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Dr. Sudhir Kumar

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