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Thus, MTTs must be differentiated from conventional MPNSTs in order to ensure prompt and aggressive treatment [1, 3]. Once diagnosed, physicians face the difficulty of determining the proper therapeutic regimen. Due to the rarity of this type of tumor; there is no treatment consensus available yet. Wide surgical excision or debulking of the tumor with negative margins and successive radiotherapy is currently often employed [4]. The role of chemotherapy, albeit unproven in efficacy, continues to be used in many cases and it must be noted that this reflects a distinct difference from MPNSTs, where adjuvant chemotherapy is sometimes not used after debulking due to the lack of survival benefit seen as mentioned by Stucky et al. [1, 9, 10]. Moreover, some investigators have employed different combinations of chemotherapy in higher doses in order to achieve a better result [http://www.selleckchem.com/products/GDC-0449.html GDC0449] in MTT patients [7]. Here we discuss two unique cases describing two sisters who were diagnosed with MTTs only a few years apart. Their presentation stands out from the literature available in their interpatient relationship, gender, and age of presentation. Although MTT is described as an exceedingly rare tumor, the fact that it occurred in two siblings in conjunction with clinical NF-1 is of interest. To our knowledge, no prior cases of MTTs occurring [https://en.wikipedia.org/wiki/Quinapyramine Quinapyramine] in siblings have been described in the literature. Additionally, MTTs in the setting of NF-1 have been described in a patient population of primarily young males [11]. Our patients are, however, female and slightly older than [http://www.selleckchem.com/products/MS-275.html MS-275 molecular weight] the age associated with NF-1. Finally, despite the aggressive behavior that characterizes this tumor type and the poor prognosis of this disease, even with rigorous therapeutic regimens, it is worthy of noting that one of the sisters remains disease-free even after 4 years of treatment. 2. Case Report We describe the presentation of malignant triton tumors in two siblings who are familiar to our cancer center. The first patient is a 36-year-old female with past medical history of asthma who presented to us with complaints of left sided chest wall swelling and mild pain that progressed over a few days. She denied the history of smoking, alcohol, or drugs. Family history was significant for colon cancer in father and maternal aunt. She was not sexually active. On examination, she was found to have axillary freckling, caf�� au lait spots, and mild cognitive impairment. The findings were consistent with NF-1. There was no associated hepatosplenomegaly noted on examination. On imaging, a very large soft tissue mass measuring 15?cm by 15?cm by 13?cm in the left lower anterior lateral chest wall with possible ulceration and axillary lymphadenopathy was seen. The mass infiltrated the adjacent chest wall musculature; however, the ribs and lungs were commented as being intact and clear, respectively (Figure 1).