Introduction Neurofibromatosis Type 1 is commonly associated with cutaneous and neurological features; however, NF1-related vasculopathy can lead to rare, life-threatening complications such as spontaneous hemothorax. This case highlights an unusual presentation of arterial rupture causing massive hemothorax and contributes to the limited literature on its diagnosis and management. Case Presentation A 50-year-old male with known NF1 presented with sudden-onset chest pain, collapse, and hemodynamic instability. Imaging revealed a massive left-sided hemothorax with active arterial extravasation from a branch of the thyrocervical trunk. The patient was managed with a massive transfusion protocol followed by urgent transcatheter arterial embolization, which successfully achieved hemostasis. He showed progressive clinical improvement in the intensive care unit and was discharged in stable condition. Conclusion Spontaneous hemothorax in NF1 is a rare but critical emergency requiring prompt recognition and rapid multidisciplinary intervention. Early imaging and endovascular embolization can be life-saving, emphasizing the need for heightened clinical awareness and timely management in such cases.
Al-Ajaji et al. (Mon,) studied this question.