Proposed algorithm for the assessment, treatment, and follow-up of pediatric patients with suspected or confirmed plexiform neurofibromas. FDG-PET/CT -fludeoxyglucose positron emission tomography; INFARMED -Autoridade Nacional do Medicamento e Produtos de Saúde; MPNST -malignant peripheral nerve sheath tumor; MRImagnetic resonance imaging; NF1 -neurofibromatosis type 1; PN -plexiform neurofibroma.

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... sheath tumor exclusion after PET-FDG/CT, normal laboratory results, and cardiac function. If the patient fulfills all of the inclusion criteria, further multi-institutional review and approval follows from local pharmacy commission, Autoridade Nacional do Medicamento e Produtos de Saúde (INFARMED), and the pharmaceutical company medical team (Fig. 1). Since April 2018, 18 patients started selumetinib treatment. Five patients are under evaluation. Eight patients did not meet all of the inclusion criteria: five had asymptomatic plexiform neurofibromas, one patient refused treatment, one patient had a malignant peripheral nerve sheath tumor and died shortly after diagnosis, and one ...