Fibrous hamartoma of infancy in the hand: unusual location and MR imaging findings

Abstract

Fibrous hamartomas of infancy (FHIs) are benign, poorly-circumscribed, soft tissue growths presenting during the first 2 years of life and characteristically affecting the axilla, upper arm, upper trunk, inguinal region, and external genital area. Involvement of the hands and feet is extremely rare. We report a case of FHI unusually occurring in a deep portion of the hand. MRI revealed atypical features similar to that of a vascular malformation, hemangioma, fibromatosis, or neurofibromatosis of the hand. Partial resection of the mass was performed to correct the contracture of the second finger and an additional operation was not performed because of the benign nature of FHIs.

Benign fibrous hamartoma of infancy: a case of MR imaging paralleling histologic findings

“…Enhancement characteristics were not described for the majority of the lesions. In cases with available post-contrast images, the enhancement pattern was heterogeneous in three [1,13,23], and minimal or absent in one [9]. There was particularly marked enhancement of the knee prepatellar lesion [1], although this lesion was atypical as it had eosinophilic infiltrate seen histologically that had not been previously reported.…”

“…Following the initial description by Loyer et al, follow-up case reports in the radiology literature focused on rare locations such as the wrist and knee, but in both of these cases, the MR appearance was less characteristic [1,23]. There have been brief descriptions of fibrous hamartoma of infancy in the radiology review literature although many of these imaging examples are from older MRI equipment, which does not characterize the typical tissue variation of the lesion as well as is seen in the current case [11,12,19].…”

“…These cases all occurred in the typical locations of the shoulder and upper back [7,12,14,19] where there is a regular pattern of the skin ligaments. All of the cases without an organizational pattern perpendicular to the skin surface occurred in atypical locations such as the wrist, prepatellar region of the knee, lower back, or abdominal wall [1,9,13,23] where skin ligament anatomy is more variable. Enhancement characteristics were not described for the majority of the lesions.…”

Fibrous Hamartoma of Infancy at the Hand: A Case Report with Complications

“…There are no descriptions of adequate margins in the literature, but reasonable care should be taken for complete excision. Staged excisions are a described treatment strategy [2]. Upon presentation, the patient was presumptively diagnosed with fibrous tumor of the hand.…”

Skin hamartoma on the hand of a newborn infant

“…Many other benign soft‐tissue and cutaneous tumors of the hand are seen in infancy and childhood . These tumors include infantile myofibromatosis, fibrous hamartoma of infancy, juvenile aponeurotic fibromatosis, palmar fibromatosis, infantile digital fibromatosis, fibroma of the tendon sheath, melorheostosis, folliculosebaceous cystic hamartoma and chondroma …”