Function-preserving microsurgical resection of a massive sporadic cervicothoracic dumbbell neurofibroma: a case report

Sporadic cervicothoracic dumbbell neurofibromas are rare and surgically challenging when large. A 44-year-old male presented with left cervical swelling, cervicobrachial pain, and C8–T1 deficits with hypothenar atrophy. Magnetic resonance imaging revealed a 6.4 × 6.6 × 11 cm C4–D3 dumbbell mass without invasion. A single-stage posterior C6–D1 laminectomy with microsurgical excision and Cavitron Ultrasonic Surgical Aspirator–assisted debulking achieved complete resection. Postoperatively, pain resolved with marked neurological recovery. Histopathology confirmed WHO Grade I neurofibroma. This case shows that even giant lesions can be safely managed with meticulous microsurgical planning.