Harper’s Textbook of Pediatric Dermatology

There are numerous soft tissue tumors and tumor-like conditions in the pediatric population. Magnetic resonance imaging is the most useful modality for imaging these lesions. Although certain soft tissue lesions exhibit magnetic resonance features characteristic of a specific diagnosis, most lesions are indeterminate, and a biopsy is necessary for diagnosis. We provide a detailed update of soft tissue tumors and tumor-like conditions that occur in the pediatric population, emphasizing each lesion's conventional magnetic resonance imaging appearance, using the recently released 5th edition of the World Health Organization Classification of Soft Tissue and Bone Tumors as a guide. In part one of this review, pediatric tumor-like lesions, adipocytic tumors, fibroblastic and myofibroblastic tumors, and perivascular tumors are discussed. In part two, vascular lesions, fibrohistiocytic tumors, muscle tumors, peripheral nerve sheath tumors, tumors of uncertain differentiation, and undifferentiated small round cell sarcomas are reviewed. Per the convention of the WHO, these lesions involve the connective, subcutaneous, and other non-parenchymatous-organ soft tissues, as well as the peripheral and autonomic nervous system.

Update of pediatric soft tissue tumors with review of conventional MRI appearance—part 1: tumor-like lesions, adipocytic tumors, fibroblastic and myofibroblastic tumors, and perivascular tumors

Infantile digital fibromatosis (IDF) is a rare benign fibrous tumor (BFT) of infancy usually limited to fingers and toes. It shows remarkable tendency towards recurrence and is characterized by the presence of intracytoplasmic eosinophilic inclusion bodies. A propensity towards spontaneous regression makes cytological diagnosis of this lesion important so as to avoid unwanted surgery which is often challenging, owing to the early age of onset, and frequent recurrence post excision. We present a case to discuss the cytomorphological features of this rare infantile lesion. This article is protected by copyright. All rights reserved.

Infantile digital fibromatosis: Clues and pitfalls for cytological diagnosis

Dear Editor, Infantile digital fibromatosis (IDF) is an uncommon benign fibrous tumor typically presenting as a skin-colored to erythematous polypoid nodule on digits in early childhood. Histologically, paranuclear eosinophilic intracytoplasmic inclusions which are composed of vimentin and actin filaments are noticeable. It is speculated that the inclusions represent a deviation in the process of myofilament assembly in myofibroblasts. The spontaneous regressive nature, with time to regression varying between 14 months to more than 3 years, supports a conservative approach when asymptomatic. For symptomatic lesions, however, there is a lack of established guidelines. A 7-year-old boy presented with a 6-month history of a relatively well-demarcated, protruding erythematous nodule on the dorso-ulnar aspect of his left index finger (Fig. 1a). The nodule caused difficulty in flexion of the distal interphalangeal joint. Five months previously, the lesion was excised at an outside clinic, but the lesion recurred 2 weeks later. Magnetic resonance imaging revealed a polypoid heterogenous tumor

Case of infantile digital fibromatosis treated with topical tacrolimus.

The golden standard of infantile digital fibromatosis treatment has not been established. This publication aims to present the process of sustained treatment of a 4-month-old boy with a red, firm, swollen, painless tumor of the third and fourth right toes and syndactyly of these. The lesion was surgically resected due to continued growth, but after 1 year of observation, local recurrence was noticed and an observational approach was implemented with satisfactory effect.

/pdf/infantile-digital-fibromatosis-which-is-better-for-a-child-a-26srxax0fi.pdf

Infantile Digital Fibromatosis—Which is Better for a Child: a Surgical or Observational Approach?

Objective: Infantile digital fibromatosis is a rare benign childhood tumor, infrequently cited in the literature. Hallmarks include nodular growths exclusive to fingers and toes and the presence of eosinophilic cytoplasmic inclusions on histology. This article aims to exemplify diagnoses of infantile digital fibromatosis and possible treatment options. Methods: A computerized English literature search was performed in the PubMed/MEDLINE database using MeSH headings "infantile," "juvenile," "digital," and "fibromatosis." Twenty electronic publications were selected and their clinical and histological data recorded and used to compile a treatment algorithm. Results: A 9-month-old male child was referred for a persistent, symptomatic nodule on the third left toe. A direct excision with Brunner-type incisions was performed under general anesthesia. The procedure was successful without complications. The patient has no recurrence at 2 years postsurgery and continues to be followed. Histological examination revealed a proliferation of bland, uniformly plump spindle cells with elongated nuclei and small central nucleoli without paranuclear inclusions consistent with fibromatosis. Conclusions: Asymptomatic nodules should be observed for spontaneous regression or treated with nonsurgical techniques such as chemotherapeutic or steroid injection. Surgical removal should be reserved for cases with structural or functional compromise.

An Algorithmic Approach to the Management of Infantile Digital Fibromatosis: Review of Literature and a Case Report.

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An Algorithmic Approach to the Management of Infantile Digital Fibromatosis: Review of Literature and a Case Report.