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Nam, Cho, Kim, Kim, and Kim: Infantile Fibrosarcoma in Neonate
Case Report
Journal of the Korean Surgical Society

Journal of the Korean Surgical Society 2010; 79(Suppl 1): S62-S66.

Published online: 31 December 2010

DOI: https://doi.org/10.4174/jkss.2010.79.Suppl1.S62

Infantile Fibrosarcoma in Neonate

So-Hyun Nam, M.D., Min-Jung Cho, M.D.1, Dae-Yeon Kim, M.D.1, Seong-Chul Kim, M.D.1, In-Koo Kim, M.D.1

Department of Surgery, Inje University Haeundae Paik Hospital, Busan, Korea.

1Department of Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.

Corresponding author (sckim@amc.seoul.kr)

Received 16 March 2010       Accepted 24 May 2010

Copyright © 2010 The Korean Surgical Society

Abstract

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.

Keywords: Infantile fibrosarcoma, Congenital lymphangioma, Congenital hemangioma, Congenital bowel obstruction

Figures and Tables

Fig. 1
(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).
jkss-79-S62-g001
Fig. 2
(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.
jkss-79-S62-g002
Fig. 3
Abdominal CT scan shows a 3.5 cm hyperdense mass at the splenic flexure, which developed bowel obstruction.
jkss-79-S62-g003

References

1. Cofer BR, Vescio PJ, Wiener ES. Infantile fibrosarcoma: complete excision is the appropriate treatment. Ann Surg Oncol. 1996. 3:159–161.
2. Kurkchubasche AG, Halvorson EG, Forman EN, Terek RM, Ferguson WS. The role of preoperative chemotherapy in the treatment of infantile fibrosarcoma. J Pediatr Surg. 2000. 35:880–883.
3. Cecchetto G, Carli M, Alaggio R, Dall'Igna P, Bisogno G, Scarzello G, et al. Fibrosarcoma in pediatric patients: results of the Italian Cooperative Group studies (1979-1995). J Surg Oncol. 2001. 78:225–231.
4. Frieden IJ, Rogers M, Garzon MC. Conditions masquerading as infantile haemangioma: Part 2. Australas J Dermatol. 2009. 50:153–170.
5. Okcu MF, Hicks J, Merchant TE, Andrassy RJ, Pappo AS, Horowitz ME. Pizzo PA, Poplack DG, editors. Nonrhabdomyosarcomatous soft tissue sarcomas. Principles and Practice of Pediatric Oncology. 2006. 5th ed. Philadelphia: Lippincott Williams & Wilkins;1055–1059.
6. Asgari M, Rubin BP, Hornung RL. Neonate with a fibrosarcoma and consumptive coagulopathy. J Am Acad Dermatol. 2004. 50:S23–S25.
7. Ramphal R, Manson D, Viero S, Zielenska M, Gerstle T, Pappo A. Retroperitoneal infantile fibrosarcoma: clinical, molecular, and therapeutic aspects of an unusual tumor. Pediatr Hematol Oncol. 2003. 20:635–642.
8. van Niekerk ML, Nel WA, Slavik T. Infantile fibrosarcoma of the ileum presenting with congenital bowel obstruction. J Pediatr Surg. 2010. 45:461–462.
9. Orbach D, Rey A, Cecchetto G, Oberlin O, Casanova M, Thebaud E, et al. Infantile fibrosarcoma: management based on the European experience. J Clin Oncol. 2010. 28:318–323.
10. Shetty AK, Yu LC, Gardner RV, Warrier RP. Role of chemotherapy in the treatment of infantile fibrosarcoma. Med Pediatr Oncol. 1999. 33:425–427.
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