2 Medical experience and current treatment plan 2.1 Her mother detected the middle stage of invasive breast cancer in September 2017,, followed by chemotherapy and radiotherapy, during which period her baby was not raised nearby 2.2 In October 2018, after find the abnormal situation, Ashley have a MRI test. The results of MRI showed that the left upper arm of lymphangioma was malformed. Surgery of children's Medical Center - Dr. Gu song suggested taking sirolimus oral solution, 0.5ml once, twice a day. The course of treatment is suggested to be 1-2 years, clinical experiment No. 182. Need to check the concentration of sirolimus every month. 2.3 In January 2019, MRI re-examination showed that the lymphangioma of the left upper arm did not improve (the range from armpit to the left upper arm was about 121.2 * 15.8 * 20.4 mm), and the skin color of the left upper arm deeper than before, so we transferred to the dermatology department for consultation. Dermatologists recommend genetic testing. The gene test report confirmed that NF1 gene mutation caused neurofibromatosis, then doctor suggested that the patient should be transferred back to surgery for treatment. Because of the involvement of muscles and nerves in diffuse tumors, surgeons recommend continuing to observe the effectiveness of drug treatment. Only consider surgery if there is a significant increase. New hemangioma treatment drugs: propranolol, 1.5 tablets (1.5 * 10mg) once, twice a day, taken with sirolimus.