The Giant Infantile Fibrosarcoma of Fetal Oropharynx and Anterior Neck

Area of Science:

• Pediatric Oncology
• Fetal Surgery
• Neonatal Care

Background:

• Infantile fibrosarcoma (IFS) is a rare soft tissue tumor typically presenting in infants within the first year of life.
• Oropharyngeal and prenatal presentations of IFS are exceptionally uncommon.
• Early detection and intervention are crucial for managing neonatal airway obstruction.

Observation:

• A giant solid mass was identified in the fetal oropharynx and anterior neck at 24 weeks gestation via ultrasound and fetal MRI.
• An EXIT (Ex-utero intrapartum treatment) procedure was successfully performed for intrapartum intubation and stabilization.
• Postpartum diagnosis confirmed infantile fibrosarcoma, with the lesion responding to neoadjuvant chemotherapy.

Findings:

• Infantile fibrosarcoma can manifest as early as 24 weeks of gestation.
• The EXIT procedure enabled immediate postnatal management and diagnosis.
• Neoadjuvant chemotherapy proved effective in treating the diagnosed infantile fibrosarcoma.

Implications:

• This case highlights the possibility of early-onset IFS, even in the prenatal period.
• The successful application of an EXIT procedure demonstrates its value in managing complex fetal neck masses.
• Early diagnosis and multimodal treatment strategies, including chemotherapy, are vital for improving outcomes in rare infantile fibrosarcoma cases.