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Infantile digital fibromas
1Division of Plastic Surgery, New England Deaconess Hospital, Harvard Medical School, Boston, MA, USA.
Insights
Infantile digital fibromas are distinct pediatric lesions appearing early in life on the fingers. These rapidly growing tumors have unique histological features and may recur after treatment.
Area of Science:
- Pediatric Dermatology
- Oncology
- Pathology
Background:
- Infantile digital fibromas are rare, benign fibrous tumors affecting infants.
- These lesions present unique clinical and histological characteristics.
- Their etiology remains unclear, with viral causes unproven.
Purpose of the Study:
- To describe the clinical presentation, histological findings, and management of infantile digital fibromas.
- To differentiate infantile digital fibromas from other pediatric digital masses.
- To highlight the potential for recurrence despite treatment.
Main Methods:
- Case series presentation of 15 lesions in 8 pediatric patients.
- Clinical data collection including age of onset, location, and growth pattern.
- Histopathological examination focusing on dermal origin and inclusion bodies.
Main Results:
- Lesions typically occur on the ulnar three digits at interphalangeal joints, showing rapid growth.
- Histology reveals deep dermal origin and unique intracytoplasmic inclusion bodies.
- Recurrence was observed even after wide excision and reconstructive surgery.
Conclusions:
- Infantile digital fibromas are a unique pediatric condition with no adult equivalent.
- Early diagnosis and consideration in the differential of pediatric digital masses are crucial.
- The potential for recurrence necessitates careful follow-up and management strategies.
Abstract:
A series of 15 digital lesions in 8 pediatric patients is presented. All infantile digital fibromas appear early in life at the distal or proximal interphalangeal joint level, characteristically involve the ulnar three digits, may be multicentric, and undergo rapid growth within a short time. Histology reveals deep dermal origin and intracytoplasmic inclusion bodies not observed in any other fibrous proliferative disorders. A viral etiology has never been proved. The lesions may recur despite wide excision followed by resurfacing with a flap or graft. This distinctive lesion has no adult counterpart and should be considered in the differential diagnosis of hard, immobile distal digital masses in children.