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Published on: September 19, 2016
A case of congenital infantile fibrosarcoma of the right hand
C Kimura1, T Kitamura, T Sugihara
1Department of Plastic and Reconstructive Surgery, Hakodate Central General Hospital, Japan.
Insights
Congenital infantile fibrosarcoma, a rare soft-tissue tumor, can present on the hand. This case highlights the aggressive nature and need for extensive surgery in infants.
Area of Science:
- Pediatric Oncology
- Surgical Pathology
- Dermatology
Background:
- Congenital infantile fibrosarcoma is a rare malignant soft-tissue tumor.
- Typically presents as limb masses in newborns.
- Early diagnosis and intervention are crucial.
Observation:
- A 12-day-old infant presented with a rapidly growing, ulcerated, and bleeding tumor on the dorsal right hand.
- Initial presentation mimicked a hemangioma but showed malignant characteristics.
- Tumor size increased significantly within 10 days, necessitating biopsy.
Findings:
- Biopsy confirmed fibrosarcoma.
- Initial resection with narrow margins led to recurrence.
- Second resection required amputation of three fingers due to tumor invasion.
Implications:
- Congenital infantile fibrosarcoma can exhibit aggressive behavior, even in newborns.
- Hand involvement presents unique surgical challenges for function preservation.
- Multifocal resection and amputation may be necessary for complete tumor removal.
Abstract:
Congenital infantile fibrosarcoma is a rare soft-tissue malignant tumor that usually presents as a mass involving the arm or leg. We report a case of congenital fibrosarcoma on the right hand of a newborn infant. The patient was a 12-day-old male. From the time of delivery, he had a red tumor on his dorsal right hand. The tumor was initially associated with bleeding within a hemangioma and compressed. The course was observed. It appeared that the tumor might be malignant because it increased in size to 10 x 8 x 3 cm, and ulceration and bleeding appeared on the surface after 10 days. A biopsy suggested a fibrosarcoma. The tumor was resected 32 days after birth at the narrow margin in consideration of preservation of function. However, a recurrence was observed under the graft after 2 weeks and another resection was performed. Because the tumor had passed through the interosseous muscle and invaded the palm of the hand, the middle finger, ring finger, and little finger had to be amputated. One year and 7 months postoperatively, no recurrence or metastasis has been observed.
