We wanted to evaluate the imaging findings of fibrous hamartoma of infancy (FHI).

We retrospectively reviewed the clinical presentation and the sonographic (n = 5) and CT (n = 3) findings of 5 cases of surgically/pathologically confirmed FHI. The sonographic findings were evaluated according to the location, size, internal echogenicity and vascularity. The CT findings were evaluated according to the attenuation of the mass on both the pre- (n = 3) and postcontrast (n = 2) scans. The image findings were correlated with the pathologic findings.

The mean age was 14.8 months (range, 7 months - 3 years). The location of lesions was all in the fatty layer of the back (n = 4) and upper arm (n = 1). All the lesions demonstrated-hypertrichosis on the overlying skin. The lesions measured 31.2 mm in the longest diameter (range: 18 mm - 50 mm). The sonographic findings were purely solid, heterogeneously hyperechoic and hypovacular for all the cases. The internal architecture revealed a 'layering' appearance (n = 3). The CT findings demonstrated isoattenuation, as compared to the adjacent muscle on both the pre- and postcontrast CT scans. The pathologic correlation demonstrated a characteristic 'organoid' mixture of fibrous, mucoid and fatty tissues in all cases.

The diagnosis of FHI can be suggested by the sonographic findings of a superficially located, heterogeneous solid mass with a 'layering' appearance in the fatty layer of the back or arms of infants with local hypertrochosis on the overlying skin.