Solitary cutaneous infantile myofibroma as a hallmark of myofibromatosis: Two cases and review of the literature

Abstract

Infantile myofibroma (IM) commonly presents as a benign cutaneous fibrous tumor in infancy. Although the majority of solitary IM regress without any morbidity, some cases have underlying bone or visceral involvement that can lead to both morbidity and mortality. In this report with review of the literature, we present two cases of solitary cutaneous IM with internal involvement and discuss screening cases of solitary IM with full body imaging.

A Recurrent Cheek Mass

“…In their review of the literature, Braun et al found that 35% of published cases had solitary cutaneous or subcutaneous IM [ 10 ]. Of those with a single lesion, 9% were later found to have bone, muscle, and visceral involvement, and up to 5% experienced morbidity or mortality (1%) related to extracutaneous involvement before undergoing full body screening [ 10 ].…”

“…In their review of the literature, Braun et al found that 35% of published cases had solitary cutaneous or subcutaneous IM [ 10 ]. Of those with a single lesion, 9% were later found to have bone, muscle, and visceral involvement, and up to 5% experienced morbidity or mortality (1%) related to extracutaneous involvement before undergoing full body screening [ 10 ]. Although there are no international published guidelines for tumor staging, various authors recommend screening patients for visceral involvement by chest X-ray, echocardiogram, and whole-body magnetic resonance imaging [ 5 , 6 , 10 ].…”

“…Although there are no international published guidelines for tumor staging, various authors recommend screening patients for visceral involvement by chest X-ray, echocardiogram, and whole-body magnetic resonance imaging [ 5 , 6 , 10 ]. Serial screening for solitary cases remains controversial [ 10 ]. In our case, due to limited resources, we opted for a CT scan of the chest, an ultrasound of the abdomen, and an X-ray of long bones that ruled out skeletal and visceral involvement with their potential morbidity.…”

“…Patients may experience morbidity related to growth retardation, vocal cord paralysis, pathologic fractures, and physical limitations due to the mass effect [ 10 ]. In vertebral IM, pathologic fractures might affect the spinal cord [ 10 ].…”

“…Patients may experience morbidity related to growth retardation, vocal cord paralysis, pathologic fractures, and physical limitations due to the mass effect [ 10 ]. In vertebral IM, pathologic fractures might affect the spinal cord [ 10 ]. On the other hand, visceral involvement in the generalized form is associated with a poorer outcome and a mortality rate reaching 76% [ 6 , 11 , 12 ].…”