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Gupta A, Sharma S, Mathur S, Yadav DK, Gupta DK. Cervical congenital infantile fibrosarcoma: a case report. J Med Case Rep 2019; 13:41. [PMID: 30797242 PMCID: PMC6387739 DOI: 10.1186/s13256-019-1968-0] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2017] [Accepted: 01/02/2019] [Indexed: 11/21/2022] Open
Abstract
Background Congenital infantile fibrosarcoma is a rare mesenchymal tumor seen in children as well as adults. The congenital variety is rare and out of the reported cases only one case sited in the neck has been reported so far. Another such case is presented here who was successfully managed. Case presentation A 3-month-old Hindu baby boy presented with a congenital neck swelling. The apparent clinical diagnosis was lympho-venous malformation. With a remote possibility of malignancy, an excisional biopsy was done. Histopathology revealed congenital infantile fibrosarcoma. Conclusion A successful excision of cervical congenital infantile fibrosarcoma has not been reported. This diagnosis should be kept as a possibility in all congenital cervical swellings. These are commonly misdiagnosed as lympho-venous malformations and histopathology is confirmatory.
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Affiliation(s)
- Alisha Gupta
- Department of Pediatric Surgery, All India Institute of Medical Sciences, New Delhi, India
| | - Shilpa Sharma
- Department of Pediatric Surgery, All India Institute of Medical Sciences, New Delhi, India.
| | - Sandeep Mathur
- Department of Pathology, All India Institute of Medical Sciences, New Delhi, India
| | - D K Yadav
- Department of Pediatric Surgery, All India Institute of Medical Sciences, New Delhi, India
| | - D K Gupta
- Department of Pediatric Surgery, All India Institute of Medical Sciences, New Delhi, India
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Akyüz C, Küpeli S, Varan A, Gedikoglu G, Yalçin B, Kutluk T, Büyükpamukçu M. Infantile Fibrosarcoma: Retrospective Analysis of Eleven Patients. TUMORI JOURNAL 2018; 97:166-9. [DOI: 10.1177/030089161109700206] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Aims and background Infantile fibrosarcomas are soft tissue sarcomas that are diagnosed at or soon after birth. In the present study, we retrospectively evaluated clinical characteristics, treatment modalities and outcome of patients diagnosed with infantile fibrosarcoma at our institution. Methods A retrospective review was conducted to evaluate demographic characteristics, presenting features, type and timing of surgery, other treatment modalities and survival characteristics. Results Nine males and 2 females were diagnosed with infantile fibrosarcoma between 1970–2008. The initial surgical procedure was subtotal resection in 4 patients, gross-total resection in 3 and biopsy in 4. Neoadjuvant chemotherapy was given to 10 patients. Three patients died, one for the disease and 2 from complications of therapy. Eight patients are under follow-up with no evidence of disease for 1.3 to 13.5 years. None of the patients in the series underwent amputation. Conclusions Owing to the chemosensitive nature of the tumor and possibility of spontaneous regression, neoadjuvant chemotherapy should be considered to prevent extensive or mutilating surgery.
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Affiliation(s)
- Canan Akyüz
- Hacettepe University Institute of Oncology, Department of Pediatric Oncology
| | - Serhan Küpeli
- Hacettepe University Institute of Oncology, Department of Pediatric Oncology
| | - Ali Varan
- Hacettepe University Institute of Oncology, Department of Pediatric Oncology
| | | | - Bilgehan Yalçin
- Hacettepe University Institute of Oncology, Department of Pediatric Oncology
| | - Tezer Kutluk
- Hacettepe University Institute of Oncology, Department of Pediatric Oncology
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See WSQ, Cheuk DKL, To KF, Ip PPC, Chiang AKS, Ha SY, Chan GCF. Congenital intestinal fibrosarcoma with rapid recurrence requiring adjuvant chemotherapy. Pediatr Int 2017; 59:733-736. [PMID: 28436622 DOI: 10.1111/ped.13252] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/21/2015] [Revised: 10/14/2016] [Accepted: 01/11/2017] [Indexed: 12/01/2022]
Abstract
A total of 16 cases of congenital fibrosarcoma have been reported from 1975 to March 2015. Five of the 16 had abnormal fusion between erythroblast transformation specific translocation variant 6 and neurotrophin recptor gene neurotrophic tyrosine kinase, receptor, type 3 (ETV6-NTRK3); in another five out of 16 this was absent, and six were not tested. All were managed by surgical resection but none involved metastasis. Herein we report the case of a newborn baby girl with congenital fibrosarcoma negative for ETV6-NTRK3 gene fusion, who presented with ileal perforation and positive resection margin. She had rapid recurrence with lymph node metastasis treated with postoperative chemotherapy. There was no further recurrence at >3 years of follow up.
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Affiliation(s)
- Wing Shan Queenie See
- Department of Paediatrics and Adolescent Medicine, Queen Mary Hospital, University of Hong Kong, Hong Kong, Hong Kong
| | - Daniel Ka Leung Cheuk
- Department of Paediatrics and Adolescent Medicine, Queen Mary Hospital, University of Hong Kong, Hong Kong, Hong Kong
| | - Ka Fai To
- Department of Anatomical and Cellular Pathology, Prince of Wales Hospital, Chinese University of Hong Kong, Hong Kong, Hong Kong
| | - Philip Pun Ching Ip
- Department of Pathology, Queen Mary Hospital, University of Hong Kong, Hong Kong, Hong Kong
| | - Alan Kwok Shing Chiang
- Department of Paediatrics and Adolescent Medicine, Queen Mary Hospital, University of Hong Kong, Hong Kong, Hong Kong
| | - Shau Yin Ha
- Department of Paediatrics and Adolescent Medicine, Queen Mary Hospital, University of Hong Kong, Hong Kong, Hong Kong
| | - Godfrey Chi Fung Chan
- Department of Paediatrics and Adolescent Medicine, Queen Mary Hospital, University of Hong Kong, Hong Kong, Hong Kong
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Kadir HKA, Chandrasekar CR. Partial fasciectomy is a useful treatment option for symptomatic plantar fibromatosis. Foot (Edinb) 2017; 31:31-34. [PMID: 28334642 DOI: 10.1016/j.foot.2017.02.002] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/23/2017] [Revised: 02/11/2017] [Accepted: 02/16/2017] [Indexed: 02/04/2023]
Abstract
Plantar fibromatosis is a rare, benign fibroproliferative disorder of the plantar fascia. It is considered as a low-grade tumour and it can be locally aggressive. It can present as painful swelling with impairment of local function. Upon failure of non-operative management, surgical treatment options include total fasciectomy or partial fasciectomy. Although surgical excision is the mainstay of treatment, recurrence rate can be up to 60%. The aim of this study was to determine the recurrence and complication rates of surgically treated plantar fibromatosis. A retrospective study was conducted involving patients who had a confirmed diagnosis and excision of plantar fibromatosis treated in our institution between 2011 and 2016. Demographic data, follow-up duration, recurrence and complications were reviewed. Eighteen patients underwent 19 operations. Mean age was 41.3 years (20-57). There were 12 male patients. The main presenting features were pain, swelling and impairment of function. They were investigated by ultrasound scan (12 feet, 63%) and/or magnetic resonance imaging (8 feet, 42%). Two patients (11%) had prior surgery at other institutions whilst 3 patients (17%) had multiple nodules at presentation. All patients underwent partial fasciectomy of the plantar fibromatosis. At up to 5 years follow-up, one patient (6%) had a recurrence in our series whilst 3 patients (17%) had scar related problems (2 patients with scar pain and one patient had hypersensitive scar that resolved after 12 months). Symptomatic plantar fibromatosis can be effectively treated with partial plantar fasciectomy.
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Affiliation(s)
- Haji Khairul Abd Kadir
- Royal Liverpool and Broadgreen University Hospitals NHS Trust, Prescot Street, Liverpool, L7 8XP, United Kingdom.
| | - Coonoor R Chandrasekar
- Royal Liverpool and Broadgreen University Hospitals NHS Trust, Prescot Street, Liverpool, L7 8XP, United Kingdom
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Hiradfar A, Pourlak T, Badebarin D. Primary Pulmonary Fibrosarcoma With Bone Metastasis: a Successful Treatment With Post-Operation Adjuvant Chemotherapy. IRANIAN JOURNAL OF CANCER PREVENTION 2015; 8:e2328. [PMID: 26413248 PMCID: PMC4581369 DOI: 10.17795/ijcp2328] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/10/2014] [Accepted: 11/05/2014] [Indexed: 11/25/2022]
Abstract
Introduction: Pulmonary fibrosarcoma has been an extremely rare tumor in children. Wide surgical resection of infantile fibrosarcoma would be the treatment of choice. Case Presentation: Post-operative chemotherapy has shown the benefit in the cases of residual disease after initial surgery and metastatic disease in the literature. We have presented the case of a 70-days old male child with primary infantile fibrosarcoma of the left lung and distant metastasis of skull. Conclusions: The aim of this publication was to highlight the role of adjuvant chemotherapy to improve outcome of infantile fibrosarcoma with residual tumor and / or metastatic disease.
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Affiliation(s)
- Amirataollah Hiradfar
- Pediatric Health Research Center, Tabriz University of Medical sciences, Tabriz, IR Iran
| | - Tala Pourlak
- Pathology Department, Tabriz University of Medical Sciences, Tabriz, IR Iran
| | - Davoud Badebarin
- Pediatric Surgery Department, Tabriz University of Medical Sciences, Tabriz, IR Iran
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Ainsworth KE, Chavhan GB, Gupta AA, Hopyan S, Taylor G. Congenital infantile fibrosarcoma: review of imaging features. Pediatr Radiol 2014; 44:1124-9. [PMID: 24706181 DOI: 10.1007/s00247-014-2957-5] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/30/2013] [Revised: 02/26/2014] [Accepted: 02/26/2014] [Indexed: 10/25/2022]
Abstract
BACKGROUND Fibrosarcoma is a rare tumor in children with limited information on imaging features of these tumors in the literature. OBJECTIVE To retrospectively review the imaging features of histologically proven congenital infantile fibrosarcoma. MATERIALS AND METHODS The list of histologically confirmed congenital infantile fibrosarcomas between November 1999 and June 2013 was obtained from the oncology-pathology database. Imaging features and pathology reports of these tumors were reviewed. Patient charts were reviewed and clinical features, management and outcomes were recorded. RESULTS During the study period, 13 children (9 girls and 4 boys; age range: 0 day-16 months, median age: 2.5 months) with congenital infantile fibrosarcomas were available for complete radiological review. The translocation (t[12;15]) was present in 11/13 (84.6%) and absent in 2/13. Eight/thirteen (61.5%) tumors were located in extremities (5 in lower and 3 in upper), 3/13 in thoracolumbar paraspinal regions, and one each in abdomen and sternocleidomastoid muscle. Imaging features included iso- to hyperintensity on T1-W, hyperintensity on T2-W as compared to skeletal muscles and heterogeneous enhancement. Six (37.5%) tumors showed hemorrhagic components and 2 (15.4%) showed low intensity foci. None of the patients had evidence of regional or distant metastases at diagnosis. Management included surgical resection only (1/13) and combined surgery and chemotherapy (10/13). Overall survival was 100% with a median follow-up of 49.3 months. CONCLUSION Congenital infantile fibrosarcoma has nonspecific imaging characteristics but should be high on the differential diagnosis in a soft-tissue tumor presenting in infancy, located in an extremity and showing tumoral hemorrhage. Patients have a favorable outcome.
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Affiliation(s)
- Kelly E Ainsworth
- Department of Diagnostic Imaging, McMaster University Medical Centre and McMaster University, Hamilton, ON, Canada
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Salman M, Khoury NJ, Khalifeh I, Abbas HA, Majdalani M, Abboud M, Muwakkit S, Solh HE, Saab R. Congenital infantile fibrosarcoma: Association with bleeding diathesis. AMERICAN JOURNAL OF CASE REPORTS 2013; 14:481-5. [PMID: 24265847 PMCID: PMC3835170 DOI: 10.12659/ajcr.889489] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2013] [Accepted: 07/26/2013] [Indexed: 11/09/2022]
Abstract
PATIENT Male, 2 month FINAL DIAGNOSIS Congenital infantile fibrosarcoma Symptoms: Bleeding Medication: Vincristine • actinomycin • cyclophosphamide Clinical Procedure: Surgical resection Specialty: Pediatric Oncology. OBJECTIVE Diagnostic/therapeutic accidents. BACKGROUND Congenital infantile fibrosarcoma (CIF) is a soft-tissue tumor occurring during the first 2 years of life, most commonly in the extremities. CIF is frequently initially misdiagnosed as a vascular tumor, but its association with bleeding and coagulopathy has not been well characterized. CASE REPORTS We describe 2 infants with CIF presenting with bleeding and coagulopathy, requiring urgent intervention. Both patients did well; one underwent partial resection followed by chemotherapy, and the other received 2 cycles of chemotherapy followed by gross total resection. We also provide a review of all reported cases of coagulopathy in the setting of CIF in the English literature, uncovering an association that seems to be more prevalent in patients diagnosed in the neonatal period, with associated anemia and thrombocytopenia, and a significant mortality rate. CONCLUSIONS CIF needs to be considered in the differential diagnosis of vascular congenital tumors, especially when there is evidence of bleeding, anemia, or thrombocytopenia.
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Affiliation(s)
- Mayssaa Salman
- Department of Pediatric and Adolescent Medicine, American University of Beirut, Beirut, Lebanon
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Sulkowski JP, Raval MV, Browne M. Margin status and multimodal therapy in infantile fibrosarcoma. Pediatr Surg Int 2013; 29:771-6. [PMID: 23765394 DOI: 10.1007/s00383-013-3318-4] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 04/16/2013] [Indexed: 12/11/2022]
Abstract
PURPOSE The rarity of infantile fibrosarcoma (IF) has precluded comprehensive treatment evaluation. The purpose of this study was to better define the extent of surgical resection required and the role of chemotherapy. METHODS Patients (0-2 years) with IF were evaluated from the National Cancer Data Base (1985-2007). Survival was estimated using the Kaplan-Meier method stratifying patients by margin status and treatment with or without chemotherapy. RESULTS Of the 224 patients, 171 (76.3 %) were <1 year of age. Of the 64 (28.6 %) with positive margins, 36 (56.3 %) had microscopic disease, 12 (18.8 %) had macroscopic disease, and 16 (25 %) had unknown margin status; none were found to have metastases. Most were managed with surgical resection (171, 76.4 %). The proportion treated with both surgery and chemotherapy increased over time (18-40 %, p = 0.025). Disease-free survival was 90.6 %. No significant survival difference was noted in this retrospective, non-randomized cohort based on margin status, nodal involvement, tumor size, or treatment modality. CONCLUSIONS The use of multimodal therapy has increased over time. There was a small increase in survival associated with negative margins and the use of multimodal therapy, however, neither result reached significance. Future studies investigating tumor biology and chemosensitivity will likely determine the optimal management of IF.
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Affiliation(s)
- Jason P Sulkowski
- Division of Pediatric Surgery, Nationwide Children's Hospital, The Ohio State University College of Medicine, 700 Children's Drive, Columbus, OH 43205, USA
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Primary giant congenital infantile fibrosarcoma of the left forearm. ACTA ACUST UNITED AC 2013; 32:265-7. [PMID: 23886865 DOI: 10.1016/j.main.2013.06.002] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2013] [Revised: 06/18/2013] [Accepted: 06/21/2013] [Indexed: 11/21/2022]
Abstract
Infantile fibrosarcoma is a rare soft tissue tumor in the infant, and only a few cases have been reported as congenital. We report a case of congenital infantile fibrosarcoma of the left forearm at birth. An amputation was performed because the tumor was relapsed soon after surgical removal, and associated with anabrosis and bleeding.
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Clinical management of infantile fibrosarcoma: a retrospective single-institution review. Pediatr Surg Int 2013; 29:703-8. [PMID: 23708972 PMCID: PMC4825685 DOI: 10.1007/s00383-013-3326-4] [Citation(s) in RCA: 41] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 05/14/2013] [Indexed: 10/26/2022]
Abstract
BACKGROUND Infantile fibrosarcoma (IFS) is an uncommon soft-tissue sarcoma. Here we review our experience treating this tumor. PATIENTS AND METHODS We retrospectively reviewed records of patients with IFS treated at St. Jude Children's Research Hospital between 1980 and 2009. RESULTS We identified 15 patients, 8 girls and 7 boys; 13 white and 2 black. Median age at diagnosis was 3 months. Primary sites included the leg (n = 3), chest wall (n = 2), foot (n = 2), and one each in the tongue, occipital region, axilla, parascapular region, arm, forearm, retroperitoneum, and thigh. All patients underwent resection; 11 upfront surgery, and 4 delayed. Complications included loss of the posterior tibial nerve and artery, axillary vein, biceps, pectoralis major, gallbladder, and transverse/sigmoid sinus. Eight received chemotherapy and three radiotherapy. Seven experienced local recurrence and three lung metastasis. Median follow-up was 65 months. At the time of the review, 12 patients were alive and 3 had died. All deaths were in patients older than 1 year at diagnosis with an axial primary site. CONCLUSIONS Non-mutilating surgery should be the primary treatment for IFS. Neoadjuvant chemotherapy is indicated when upfront resection is unfeasible. Patients with positive surgical margins should receive adjuvant chemotherapy. Radiotherapy is indicated for axial primary sites where complete resection is impossible.
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Shah NN, Price MR, Loeb DM. Cardiac metastasis and hypertrophic osteoarthropathy in recurrent infantile fibrosarcoma. Pediatr Blood Cancer 2012; 59:179-81. [PMID: 21853519 PMCID: PMC4273568 DOI: 10.1002/pbc.23321] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/04/2011] [Accepted: 07/19/2011] [Indexed: 11/08/2022]
Abstract
Cardiac metastasis and hypertrophic osteoarthropathy are both quite rare. We describe a patient presenting with hypertrophic osteoarthropathy as the first symptom of recurrent infantile fibrosarcoma (IF). During surgical resection of lung metastasis, the patient suffered sudden cardiac arrest. Autopsy demonstrated a metastatic lesion in the intraventricular septum of the heart, which is previously undescribed in the literature. This case demonstrates that IF can be aggressive despite its more typical benign course.
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Affiliation(s)
- Nirali N. Shah
- Division of Pediatric Oncology, Department of Oncology, Johns Hopkins University, Baltimore, Maryland
| | - Mitchell R. Price
- Division of Pediatric Surgery, University of Illinois Medical Center, Chicago, Illinois
| | - David M. Loeb
- Division of Pediatric Oncology, Department of Oncology, Johns Hopkins University, Baltimore, Maryland,Correspondence to: David M. Loeb, MD, PhD, Division of Pediatric Oncology, Department of Oncology, Johns Hopkins University, 600 N. Wolfe Street, CMSC 800, Baltimore, Maryland 21287.
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Gupta SS, Singh O, Sharma SS, Mathur RK. Congenital fibrosarcoma of the chest wall: report of a case. J Cutan Aesthet Surg 2011; 3:177-80. [PMID: 21430833 PMCID: PMC3047738 DOI: 10.4103/0974-2077.74497] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Congenital fibrosarcoma (CFS) is a rare soft tissue tumour that usually occurs before the age of 1, and involves the distal extremities. The literature regarding the precise diagnosis and treatment of these tumours is limited. We present and discuss a case of CFS which ended fatally due to lung metastasis after 2 years.
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Affiliation(s)
- Shilpi Singh Gupta
- Department of Surgery, MGM Medical College and MY Hospital, Indore, Madhya Pradesh, India
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