Unusual localization and aggressive progression of large infantile fibrosarcoma

Area of Science:

• Pediatric Oncology
• Surgical Oncology
• Pediatric Pathology

Background:

• Infantile fibrosarcoma is a rare pediatric soft tissue tumor, typically with a good prognosis and infrequent metastasis.
• While local recurrence is common, distant metastasis is rare in infantile fibrosarcoma.
• Pelvic localization is uncommon, and surgical management presents unique challenges.

Observation:

• A 2-year-old girl presented with a large pelvic infantile fibrosarcoma.
• The patient received neoadjuvant chemotherapy followed by type 1 pelvic resection and reconstruction.
• Six months post-surgery, the patient experienced relapse with lung metastasis.

Findings:

• This case represents the first reported instance of pelvic infantile fibrosarcoma treated with pelvic resection surgery.
• Despite aggressive multimodal treatment, including neoadjuvant chemotherapy, surgery, and adjuvant chemotherapy, the patient developed distant metastasis.
• The tumor exhibited aggressive behavior with early relapse and lung metastasis.

Implications:

• Pelvic infantile fibrosarcoma may have a more aggressive clinical course than previously understood.
• This case underscores the need for vigilant surveillance and potentially novel therapeutic strategies for pelvic infantile fibrosarcoma.
• Further research is warranted to understand the biological behavior and optimize treatment protocols for this rare tumor presentation.