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Fibrosarcoma in infants and children: a review of 110 cases
Insights
Pediatric fibrosarcoma shows lower metastatic rates in young children (<5 years). Early local excision is recommended for this age group, as recurrence does not increase metastatic risk.
Area of Science:
- Pediatric Oncology
- Surgical Pathology
- Cancer Epidemiology
Background:
- Fibrosarcoma is a rare malignant mesenchymal tumor affecting children.
- Understanding age-specific clinicopathologic features is crucial for treatment strategies.
Purpose of the Study:
- To summarize clinicopathologic findings in 110 pediatric fibrosarcoma cases.
- To analyze age-related differences in metastatic spread and recurrence.
- To inform treatment recommendations for pediatric fibrosarcoma.
Main Methods:
- Retrospective analysis of 110 pediatric fibrosarcoma cases (70 from literature, 40 from institutional files).
- Histologic criteria consistent with adult fibrosarcoma diagnosis were applied.
- Patients were stratified by age: <5 years, 5-9 years, and 10+ years.
Main Results:
- A total of 110 children were included, with the majority (68) under 5 years old.
- Local recurrence rate was 43% in children <5 years, with a 7.3% chance of metastatic spread.
- Children aged 10+ years had a 5-year metastatic rate of 50%, similar to adults.
- Tumor recurrence did not appear to increase the risk of metastasis.
Conclusions:
- Infants and children under 5 years with fibrosarcoma may be candidates for initial local excision.
- This approach aims to preserve function without significantly increasing metastatic risk.
- Older children (>10 years) exhibit metastatic rates comparable to adult fibrosarcoma patients.
Abstract:
This retrospective study summarizes the clinicopathologic findings in 110 children with fibrosarcoma. Seventy cases were selected from previous reports and 40 were from our files. The histologic criteria used for diagnosis are the same as those used for adults. Sixty-eight patients were in the first quinquennium of life, 13 in the second, and 29 in the third. Eleven patients died of their tumor, three in the first quinquennium and eight in ght third. Our findings indicate that children who are less than 5 years old have a 7.3% chance of developing metastatic spread even though the local recurrence rate is 43%. Children who are 10 years old or older had a metastatic rate of 50% at 5-year follow-up, a figure closely approximating that for adults. We believe that infants and children less than 5 years old may be treated initially by local excision of the lesion, without sacrificing significant function of the part. Recurrent tumor does not seem to predispose to metastatic disease.
