Neurofibromatosis type 1 (NF1) is one of the most frequently encountered familial tumor syndromes. NF1 patients are highly prone to have multiple nervous system tumors, and are also at increased risk for various nonnervous mesenchymal or neuroendocrine tumor developments. This is an NF1 patient who developed two different unusual tumors: an intramedullary anaplastic astrocytoma of the thoracic spine and myxoid liposarcoma of the lower limb. The family members were carefully investigated as per the NF1 diagnostic criteria. A strong cutaneous NF1 penetrance was found in 6 of the 14 family members in four successive generations, two of whom had NF1 and developed breast cancer and bilateral optic gliomas. The NF1 tumor syndrome highlights a wide‑ranging tumor spectrum, and clinicians should keep an eye on tumor surveillance and encourage medical counseling, and long‑term NF1 family follow‑up is warranted for prophylactic warning.