It is increasingly clear that neurofibroma formation requires a microenvironment containing bone marrow-derived cells that are heterozygous at Nf1. [28] These biological factors could be important during development (e.g., for congenital lesions like plexiform neurofibromas) or post-natally (e.g., for non-congenital lesions like vestibular schwannomas). This evidence concerns the gene NF1 and Vestibular schwannoma.