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This 7-month-old girl presented with a swelling around the left eye in the area of the lacrimal gland. On palpation it was described as “soft and fleshy”. During the evaluation several tan, pigmented lesions were seen on her abdomen as shown in the figure above.

1.	This finding suggests the possibility that the swelling represents:
	c -- a plexiform neuroma The finding of a “soft and fleshy” mass at the orbital rim in a patient with skin lesions that could be called café-au-lait spots suggests the likelihood of neurofibromatosis, Von Recklinghausen’s disease.
2.	Treatment should be:
	b -- simply observing the patient The patient should be observed.  These lesions are excised only if they create problems for the patient by their mass.
3.	This condition is likely to be:
	e -- all of the above Neurofibromatosis is transmitted as an autosomal dominant, but can occur without a family history.  Multiple lesions tend to occur over time, but treatment should be carried out only when the masses create problems for the patient.