J Korean Surg Soc JKSS Journal of the Korean Surgical Society 1226-0053 2093-0488 The Korean Surgical Society 10.4174/jkss.2010.79.Suppl1.S62 Case Report Infantile Fibrosarcoma in Neonate Nam So-Hyun M.D. Cho Min-Jung M.D. 1 Kim Dae-Yeon M.D. 1 Kim Seong-Chul M.D. 1 Kim In-Koo M.D. 1 Department of Surgery, Inje University Haeundae Paik Hospital, Busan, Korea. Department of Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea. Corresponding author (sckim@amc.seoul.kr) 12 2010 31 12 2010 79 Suppl 1 S62 S66 16 03 2010 24 05 2010 Copyright © 2010 The Korean Surgical Society 2010

Infantile fibrosarcoma is a rare malignant soft tissue tumor occurring especially in newborn and young children under 2 years. We experienced three cases of infantile fibrosarcoma presenting in the neonatal period. Case 1 presented with a multiseptated cystic mass on his left thigh at birth that was diagnosed as lymphangioma. After picibanil injection, we noted the size of the mass doubled and a solid lesion was prominent in the magnetic resonance image. Case 2 was found to have a reddish mass on his lower back mimicking hemangioma. Over 2 weeks, the mass grew rapidly with internal hemorrhaging. Case 3 was noted to have an encircling mass around the splenic flexure, which developed into congenital bowel obstruction. All of the tumors were resected completely, but microscopic resection margin was not clear in two patients. The two patients received adjuvant chemotherapy and all patients are well without evidence of recurrence.

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(A) Ultrasonography shows multiseptated cystic mass with internal hemorrhage on the left thigh. (B) Coronal T2 weighted MR image reveals a huge mass with remarkable solid portion and lesional heterogeneity. (C) Cut surface appearance of gross specimen shows grayish white solid mass with internal hemorrhage and necrosis. (D) Microscopic examination shows herringbone pattern of spindled fibrosarcoma cell with high cellularity and mitosis (H&E stain, ×400).

(A) Sagittal T2 weighted MR image reveals a hyperintense homogenous, well defined mass on the back without connection to spinal canal. (B) The exophytic hard mass is rapidly growing with the overlying skin stretching with ulceration.

Abdominal CT scan shows a 3.5 cm hyperdense mass at the splenic flexure, which developed bowel obstruction.