Neurofibroma - Symptoms, Causes & Treatment
Medically reviewed by Dr. Anand S. Urhekar, MD, MD Pathology, Clinical Advisor · Last updated July 2026
A benign tumour of the nerve sheath that presents as a soft, skin-coloured or slightly pink lump that can be pushed inwards with light pressure (the 'buttonhole' sign). Single neurofibromas are common and harmless; multiple lesions with café-au-lait macules suggest neurofibromatosis type 1.
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Quick Answer
A neurofibroma is a soft, benign lump arising from nerve-sheath cells. It is usually skin-coloured or pink, painless, and characteristically invaginates when pressed. A solitary neurofibroma needs no treatment. Multiple neurofibromas together with café-au-lait patches and freckling in the armpits point to neurofibromatosis type 1, an inherited condition requiring genetic and specialist review.
Symptoms
- Soft, rubbery, skin-coloured or pink papule or nodule
- 'Buttonhole' sign — the lump invaginates under finger pressure
- Usually painless, occasionally itchy or tender
- May slowly enlarge, particularly during pregnancy
- In NF1: many lesions plus café-au-lait macules and axillary freckling
Causes & Risk Factors
- Sporadic growth of Schwann cells and fibroblasts in a nerve sheath
- Neurofibromatosis type 1 (NF1 gene mutation) when multiple
- Hormonal influence — lesions may grow in pregnancy
Treatment & Management
- No treatment needed for asymptomatic solitary lesions
- Surgical excision for painful, irritated or cosmetically troublesome lumps
- Referral to genetics and NF specialist clinic if NF1 suspected
- Long-term monitoring of plexiform neurofibromas for malignant change
When to See a Doctor
See a doctor if a neurofibroma becomes painful, hard, rapidly enlarges, or if you have several lumps together with café-au-lait patches — the latter needs assessment for neurofibromatosis type 1.
Frequently Asked Questions
Are neurofibromas cancerous?
Cutaneous neurofibromas are benign. Deep plexiform neurofibromas in neurofibromatosis type 1 carry a small lifetime risk of transforming into a malignant peripheral nerve sheath tumour, which is why rapid growth or new pain should be reported.
Do neurofibromas grow back after removal?
A completely excised lesion rarely recurs at the same site, but people with NF1 typically continue to develop new lesions elsewhere.
How is a neurofibroma different from a skin tag?
Skin tags are thin, stalked flaps of skin found in folds. Neurofibromas are deeper, softer and characteristically buttonhole inwards when pressed.
Related Conditions
Medical References
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Medical Disclaimer: This information is for educational purposes only and is not intended as medical advice. The content on this page should not be used to diagnose or treat any health problem. Always consult with a qualified healthcare professional for proper medical evaluation, diagnosis, and treatment of your condition.