Neonate with a fibrosarcoma and consumptive coagulopathy

We report a case of a neonate with a congenital tumor on the left palm. The patient had a grapefruit-sized tumor and coagulopathy at birth and was presumed to have a hemangioendothelioma with associated Kasabach-Merritt phenomenon. When the tumor failed to respond to systemic steroids, a biopsy specimen was taken, revealing a fibrosarcoma. We describe this case to highlight the importance of including rare tumors, such as fibrosarcomas, in the clinical differential when evaluating a congenital tumor with associated coagulopathy. We discuss subtle differences in clinical presentations that might aid in differentiating vascular tumors from fibrosarcomas.