Mimickers of Infantile Hemangiomas

Abstract

Infantile hemangiomas (IHs) are the most common tumors of infancy and usually follow a typical course of growth and involution. We report four soft tissue tumors that were referred to the pediatric dermatology clinic as IHs and the process by which they were diagnosed and treated. Clinicians should be aware of presentations of these uncommon, but serious soft tissue tumors. Many of these mimickers have a vastly different clinical prognosis, and early intervention to limit sequelae is crucial. Biopsy of atypical lesions should be considered early in the diagnostic process since they have varied prognosis and treatment strategies.

Pyrites: A Perineal Mass

“…1 Other considerations would be congenital fibromatoses, fibrosarcoma 2 or another soft tissue sarcoma. 3 Neurofibromatosis would rarely present at this age. Ruling out benign (treatable) dermatologic problems is important.…”

“…Subcutaneous nodules are an unusual presentation for malignancy in the neonatal period. The most common diagnosis is neuroblastoma and the child often appear like a “blueberry muffin.”1 Other considerations would be congenital fibromatoses, fibrosarcoma2 or another soft tissue sarcoma 3. Neurofibromatosis would rarely present at this age.…”

How we approach hemangiomas in infants

“…As evidenced by case 7, cutaneous lesions that appear vascular may instead be LCH, a clonal disorder of histiocytes with a disease spectrum from single‐system self‐limited course to multisystem involvement that is life threatening 93 . Table S1 summarizes numerous malignant and benign conditions that can be distinguished by their clinical presentation, imaging, lab findings, histologic features, and somatic and germline gene analysis 91–104 . Accurate diagnosis is paramount to providing the appropriate management and prognosis.…”

“…93 Table S1 summarizes numerous malignant and benign conditions that can be distinguished by their clinical presentation, imaging, lab findings, histologic features, and somatic and germline gene analysis. [91][92][93][94][95][96][97][98][99][100][101][102][103][104] Accurate diagnosis is paramount to providing the appropriate management and prognosis.…”