Suspected homicide of a 67-year-old woman with neurofibromatosis type 1

A 67-year-old woman with von Recklinghausen's disease (neurofibromatosis type 1) and disfiguring neurofibromas was found dead in the hallway by her husband. The emergency services were notified and after a failed attempt at resuscitation the emergency doctor noted an obvious profusely bleeding lacerated contused wound above the hat brim line and notified the police. Because homicide was suspected an autopsy was ordered which, however, revealed that the cause of death was decompensated cardiac insufficiency with predominantly right-sided heart failure. A superficially lacerated neurofibroma on the head was identified as the source of bleeding. Neurofibromas are very susceptible to damage and can bleed profusely and thus mimic trauma from inflicted violence. There also needs to be awareness that in the case of corpses with disfigurements, a certain inhibition threshold can be present on the side of the examiner to correctly carry out an external examination of the body.