2.4 In April 2019, a new lesion was found in the neck by MRI (the doctor thought it was not a new lesion but had not been detected before). Irregular occupying changes were found at the right cervical root and beside the double upper mediastinum spine. T1W showed low signal, T2W showed high signal and dot low signal. The range of cross-section is about (27.7 * 13.3 * 29.3mm). In October, the maximum range of cross-section is 26.6 * 13.2 * 65.5mm as shown by MRI plain scan of neck again. 2.5 In October 2019, MRI scan of the head showed midbrain, bilateral cerebellar dentate nucleus, patchy abnormal signal shadow in bilateral pallidum, low signal in T1W, high signal in T2W, high signal in flair, no obvious diffusion limitation in dw1, no obvious peripheral edema. T1W low signal, T2W high signal and flair high signal were found in bilateral mastoid. Radiology diagnosis, midbrain, bilateral cerebellar dentate nucleus, bilateral globus pallidus signal abnormalities, combined with clinical, consider NF-1, mastoid muscle fluid. Surgeons suggest adding a drug-assisted treatment together with sirolimus: metformin hydrochloride 0.25 tablets * 0.5g each time, three times a day.