MR Emilia Rosniza, CD Che Zubaidah, T Arni, MZ Faizah

Abstract

Infantile fibrosarcoma (IF) is a rare malignant soft tissue tumour in infancy. It can be mistaken as a benign vascular tumour as both share similar clinical presentation and imaging features. We present a 4-month-old girl that initially presented with a small red spot lesion over the right wrist since two weeks of life which had progressively increased in size. The magnetic resonance imaging features were suggestive of a benign vascular tumour that was thought to be an infantile haemangioma. Child underwent total excision of the lesion. However, histopathological examination revealed an infantile fibrosarcoma. We discuss and highlight the radiological features of IF, which often overlaps with vascular benign tumour and also discuss some of the salient features to differentiate between these two diagnoses, as it will lead to different prognosis and management. We believed that in a large soft tissue lesion, whenever the size increases rapidly and disproportionate to the growth of the child, a malignant lesion needs to be excluded and IF should be in the differential diagnosis especially when there is additional presence of intratumoural bleed.