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Published on: July 1, 2020
[Solitary cutaneous infantile myofibromatosis]
Thomas Petit1, Maggy Grossin, Sylvie Fraitag
1Service d'anatomie et de cytologie pathologiques, Hôpital Bichat - Claude Bernard, 46 rue Henri Huchard, 75018 Paris. tom.petit@online.fr
Insights
Infantile myofibromatosis (IMF) is a common childhood fibromatosis. This case highlights a newborn with a scalp nodule diagnosed as IMF, emphasizing its varied presentations and prognosis based on type.
Area of Science:
- Pediatric Pathology
- Dermatology
- Surgical Oncology
Background:
- Infantile myofibromatosis (IMF) is the most prevalent fibromatosis in childhood.
- It represents a benign proliferation of fibroblasts and myofibroblasts.
- IMF can manifest in solitary, multicentric, or generalized forms with visceral involvement.
Observation:
- A newborn presented with a purple cutaneous nodule on the scalp at birth.
- Surgical excision was performed at 16 months of age.
- Histological examination confirmed infantile myofibromatosis.
Findings:
- Histological diagnosis of IMF relies on identifying a fascicular myofibroblastic pattern peripherally and a hemangiopericytoma-like pattern centrally.
- Both components typically express alpha-smooth muscle actin.
- While solitary IMF has a good prognosis, generalized forms with visceral involvement are often fatal.
Implications:
- This case underscores the importance of accurate histological diagnosis for appropriate management of infantile myofibromatosis.
- Understanding the different forms of IMF is crucial for predicting patient outcomes.
- Early recognition and surgical intervention may be beneficial for localized lesions.
Abstract:
Infantile myofibromatosis is the most frequent fibromatosis in childhood. It is a benign proliferation of fibroblasts and myofibroblasts. This case report concerns a newborn who presented at birth with a purple cutaneous nodule on the scalp. Surgical excision was performed at the age of 16 months. Infantile myofibromatosis was diagnosed on histology. Infantile Myofibromatosis (IMF) was first described by Enzinger in 1981. Three types can exist. Solitary MFI, the most frequent, is a solitary lesion, cutaneous/subcutaneous, osseous or involving soft tissues. Multicentric disease is characterized by multiple locations and generalized form by visceral involvement. Morphological features are identical in all types. The histological diagnosis relies on the identification of two separate components, a fascicular myofibroblastic pattern at the periphery with a hemangiopericytoma like pattern in the centre. Both components are positive for alpha-smooth muscle actin. Atypia, or mitotic activity, are not observed usually but features of intravascular growth can be seen in the centre of the lesion. Infantile MF carries a good prognosis when solitary but death frequently occurs in generalized MF with visceral involvement.
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