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Obayashi J, Koizumi H, Hoshikawa M, Wakisaka M, Fujikawa A, Kitagawa H, Takagi M. A Case of Congenital Infantile Fibrosarcoma of the Bowel Presenting as a Neonatal Intussusception. Pathol Int 2017; 67:644-648. [PMID: 29090505 DOI: 10.1111/pin.12603] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2017] [Accepted: 09/20/2017] [Indexed: 11/29/2022]
Abstract
Neonatal intussusception of the intestinal tract is rare. However, most neonatal intussusceptions have an organic lead point. For the lead point to be a neoplasm is extremely rare. We report a case that presented with neonatal intussusception with a congenital infantile fibrosarcoma as the lead point. The detection of ETV6-NTRK3 gene fusion was useful, although the definitive diagnosis was achieved by a comprehensive evaluation including this gene analysis, standard histology and immunohistochemistry. Neonatal intussusception should be suspected to be caused by a neoplasm. If pathological diagnosis is difficult, molecular analysis should be utilized to diagnose congenital infantile fibrosarcoma.
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Affiliation(s)
- Juma Obayashi
- Department of Pathology, St. Marianna University School of Medicine, Kawasaki, Japan
- Division of Pediatric Surgery, St. Marianna University School of Medicine, Kawasaki, Japan
| | - Hirotaka Koizumi
- Department of Pathology, St. Marianna University School of Medicine, Kawasaki, Japan
| | - Masahiro Hoshikawa
- Department of Pathology, St. Marianna University School of Medicine, Kawasaki, Japan
| | - Munechika Wakisaka
- Division of Pediatric Surgery, St. Marianna University School of Medicine, Kawasaki, Japan
| | - Atsuko Fujikawa
- Department of Radiology, St. Marianna University School of Medicine, Kawasaki, Japan
| | - Hiroaki Kitagawa
- Division of Pediatric Surgery, St. Marianna University School of Medicine, Kawasaki, Japan
| | - Masayuki Takagi
- Department of Pathology, St. Marianna University School of Medicine, Kawasaki, Japan
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2
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Congenital Infantile Fibrosarcoma Causing Intestinal Perforation in a Newborn. Case Rep Pediatr 2017; 2017:2969473. [PMID: 28690909 PMCID: PMC5485274 DOI: 10.1155/2017/2969473] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2017] [Accepted: 05/21/2017] [Indexed: 12/01/2022] Open
Abstract
Congenital infantile fibrosarcoma (CIF) is a rare malignant mesenchymal tumor and only 14 cases have been reported with gastrointestinal manifestation. We report about a female newborn delivered per emergency cesarean section at 34 weeks of gestation. Postnatally, she rapidly developed an acute abdomen and sonographic evidence of intestinal perforation requiring laparotomy on the first day of life. A perforated 2 × 3 cm sized spherical tumorous structure of the jejunum was identified. Due to unknown histopathology at this point and unclear resectional margins, she received a temporary ileostomy, which was closed two months later. Histopathology revealed a congenital intestinal fibrosarcoma without the characteristic ETV6-NTRK3 fusion transcript. In conclusion, this rare tumor must be considered as differential diagnosis of intestinal perforations in newborns.
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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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Zeytun H, Okur MH, Basuguy E, Arslan S, Aydogdu B, Turkcu G, Arslan MS. Congenital-infantile fibrosarcoma of the ileocecal region: the first case presentation. Pediatr Surg Int 2016; 32:97-9. [PMID: 26527581 DOI: 10.1007/s00383-015-3802-0] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 10/12/2015] [Indexed: 11/29/2022]
Abstract
Infantile fibrosarcoma is a very rare soft tissue tumor that originates most commonly in the body and extremities. We present a neonate with an infantile fibrosarcoma that originated in the ileocecal region and was detected incidentally without symptoms. This is the first case of fibrosarcoma reported in the ileocecal region.
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Affiliation(s)
- Hikmet Zeytun
- Department of Pediatric Surgery, Dicle University Faculty of Medicine, 21100, Diyarbakir, Turkey.
| | - Mehmet Hanifi Okur
- Department of Pediatric Surgery, Dicle University Faculty of Medicine, 21100, Diyarbakir, Turkey
| | - Erol Basuguy
- Department of Pediatric Surgery, Dicle University Faculty of Medicine, 21100, Diyarbakir, Turkey
| | - Serkan Arslan
- Department of Pediatric Surgery, Dicle University Faculty of Medicine, 21100, Diyarbakir, Turkey
| | - Bahattin Aydogdu
- Department of Pediatric Surgery, Dicle University Faculty of Medicine, 21100, Diyarbakir, Turkey
| | - Gul Turkcu
- Department of Pediatric Surgery, Dicle University Faculty of Medicine, 21100, Diyarbakir, Turkey
| | - Mehmet Serif Arslan
- Department of Pediatric Surgery, Dicle University Faculty of Medicine, 21100, Diyarbakir, Turkey
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Intestinal congenital/infantile fibrosarcoma: a new clinico-pathological entity? Pediatr Surg Int 2015; 31:375-9. [PMID: 25652760 DOI: 10.1007/s00383-015-3670-7] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 01/27/2015] [Indexed: 10/24/2022]
Abstract
Congenital/infantile fibrosarcoma (IFS) is a relatively rare form of fibrosarcoma diagnosed at birth or during early years of life and that differs from its adult counterpart because of a more favorable behavior. IFS is also known as cellular congenital mesoblastic nephroma, when it affects the kidney and is often but not always characterized by the ETV6-NTRK3 fusion transcript. We report herein the first series of an exceptional tumor of the small intestine occurring in newborns. The four patients shared a stereotyped clinico-pathological presentation with early and acute onset, intestinal perforation, and an infiltration by a highly cellular spindle cell tumor within the dilated intestinal wall exhibiting pathologic features typical of IFS. Molecular studies for the ETV6-NTRK3 translocation were negative in the three cases tested. Patients were treated by surgical wide resection alone and are alive and well (follow-up: 36 months-25 years). Thus, this new clinico-pathological entity, even with lack of documented evidence of the ETV6-NTRK3 translocation, should be included in the differential diagnosis of congenital bowel perforation or obstruction and may represent an intestinal counterpart of IFS.
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Parmar V, Peters RT, Cheesman E, Edi-Osagie N, Craigie RJ. Congenital infantile fibrosarcoma of the colon: a case series and literature review. Pediatr Surg Int 2014; 30:1079-85. [PMID: 25150723 DOI: 10.1007/s00383-014-3589-4] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 08/15/2014] [Indexed: 11/26/2022]
Abstract
Congenital infantile fibrosarcoma is rare and only three cases affecting the colon have previously been reported. We describe two further cases that presented in the neonatal period and were both successfully treated with surgical excision and have no evidence of recurrence or metastasis at 31 and 27 months follow-up, respectively.
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Affiliation(s)
- Vijal Parmar
- Neonatal Intensive Care Unit, Saint Mary's Hospital, Manchester, UK,
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Bruno C, Caliari G, Zampieri N, Segala D, Pozzi-Mucelli R. Congenital fibrosarcoma of the bowel: sonographic description of a rare case of neonatal intestinal obstruction. JOURNAL OF CLINICAL ULTRASOUND : JCU 2014; 42:363-366. [PMID: 24281989 DOI: 10.1002/jcu.22117] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/29/2012] [Revised: 06/22/2013] [Accepted: 10/09/2013] [Indexed: 06/02/2023]
Abstract
A case of localization in the bowel of congenital fibrosarcoma (a rare soft-tissue tumor usually occurring in the extremities) causing intestinal obstruction in a newborn girl is described. A focal thickening of the ileal wall with features mimicking intussusception was identified at sonography; the final diagnosis was achieved by means of molecular analysis after surgical removal of the mass.
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Affiliation(s)
- Costanza Bruno
- Department of Radiology, University of Verona, P.le LA Scuro 10, 37134, Verona, Italy
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Sulkowski JP, Nicol K, Raval MV, Yeager N, Setty B, Groner JI, Aldrink JH. Infantile fibrosarcoma of the intestine: A report of two cases and literature review. JOURNAL OF PEDIATRIC SURGERY CASE REPORTS 2014. [DOI: 10.1016/j.epsc.2014.06.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022] Open
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Kim HY, Cho YH, Byun SY, Park KH. A case of congenital infantile fibrosarcoma of sigmoid colon manifesting as pneumoperitoneum in a newborn. J Korean Med Sci 2013; 28:160-3. [PMID: 23341728 PMCID: PMC3546097 DOI: 10.3346/jkms.2013.28.1.160] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/05/2012] [Accepted: 09/13/2012] [Indexed: 01/31/2023] Open
Abstract
Congenital infantile fibrosarcoma (CIF) is a rare soft-tissue tumor in the pediatric age group and seldom involves the gastrointestinal tract. A 2-day-old boy was transferred to our hospital with a pneumpoperitoneum. After emergency operation, we could find a solid mass wrapping around a sigmoid colon and performed a segmental resection of sigmoid colon including a mass. Histopathologic examination showed an infantile fibrosarcoma origining from the muscular layer of colon. The baby was discharged on the 17th hospital day and followed for 1 yr without recurrence.
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Affiliation(s)
- Hae Young Kim
- Division of Pediatric Surgery, Department of Surgery, Pusan National University School of Medicine, Yangsan, Korea
| | - Yong Hoon Cho
- Division of Pediatric Surgery, Department of Surgery, Pusan National University School of Medicine, Yangsan, Korea
| | - Shin Yun Byun
- Department of Pediatrics, Pusan National University School of Medicine, Yangsan, Korea
| | - Kyung Hee Park
- Department of Pediatrics, Pusan National University School of Medicine, Yangsan, Korea
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Different clinical manifestations between primary gastrointestinal malignancies and benign tumors in children. J Pediatr Gastroenterol Nutr 2012; 55:440-4. [PMID: 22343909 DOI: 10.1097/mpg.0b013e31824e88eb] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
OBJECTIVE The purpose of the present study was to review the different clinical manifestations of primary gastrointestinal (GI) malignancies and benign tumors in pediatric patients. METHODS The demographic data, duration to diagnosis, clinical features, laboratory data, location and pathology of the tumors, and outcomes of pediatric patients from January 1984 to December 2009 were retrospectively reviewed. RESULTS A total of 24 GI malignancies and 62 benign tumors were diagnosed. Patients in the benign group were mostly diagnosed in the first decade of life (73%), whereas majority of patients with malignancies were older than 10 years (79%). The most common tumor location in the benign group was the colorectum, whereas in the malignant group, tumors were distributed equally in the small intestine and colorectum. The median duration from onset to diagnosis in the benign group was longer than that of the malignant group (P>00.05). There was statistically significant increase in the presence of hematochezia in patients with benign tumor compared with those with malignancy (P<00.05). Among the malignancies, 79% presented with abdominal pain, followed by weight loss (25%), anorexia (25%), palpable mass (25%), and fever (21%), with statistically significant differences compared with the benign group (P<00.05). Anemia was found in 47% to 63% of patients in both groups (P>00.05). Two patients with polyposis subsequently developed malignancy. CONCLUSIONS Different manifestations of GI malignancies and benign tumors may help pediatricians to detect these early. Patients with polyposis should be aware of the risk of malignant change.
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Steelman C, Katzenstein H, Parham D, Stockwell C, Ricketts R, Abramowsky C, Bridge JA, Sorensen PH, Kenney B, Olson T, Igbokwe A, Lopez-Terrada D, Shehata B. Unusual presentation of congenital infantile fibrosarcoma in seven infants with molecular-genetic analysis. Fetal Pediatr Pathol 2011; 30:329-37. [PMID: 21843073 DOI: 10.3109/15513815.2011.587497] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Congenital infantile fibrosarcoma (CIFS) is a rare mesenchymal tumor that primarily presents in the soft tissue of the distal extremities and occasionally in unusual locations such as the lung and retroperitoneum. Herein, we report seven cases of unusual presentations of CIFS. These cases include three in the lungs, one in the retroperitoneum with cord compression, one in the posterior trunk, one in the heart, and one infratemporal involving the sphenoid bone. All tumors demonstrated CIFS's characteristic t(12;15)(p13;q25) and associated ETV6-NTRK3 gene fusion. One of the three lung cases was previously reported as primary bronchopulmonary fibrosarcoma (PBPF), but molecular analysis of the paraffin embedded tissue revealed the ETV6-NTRK3 gene fusion consistent with CIFS. We show that CIFS may occur in unusual sites including visceral locations, and we propose that neoplasms displaying the ETV6-NTRK3 gene fusion represent the visceral components of CIFS.
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Affiliation(s)
- Charlotte Steelman
- Department of Pediatric Pathology, Children's Healthcare of Atlanta, Emory University, Atlanta, GA 30322, USA
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Demir HA, Akyüz C, Varan A, Ergen FB, Büyükpamukçu M. Right foot congenital infantile fibrosarcoma treated only with chemotherapy. Pediatr Blood Cancer 2010; 54:618-20. [PMID: 19998472 DOI: 10.1002/pbc.22389] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Congenital infantile fibrosarcoma (CIF) is a rare tumor in childhood. The 5-year survival rate for CIFs is high and has been reported between 84% and 93%, but limb-amputation/disarticulation is still a major problem. We report the case of a male newborn with a mass in his right foot. X-ray and MRI revealed a mass destroying all tarsal, metatarsal, and phalangeal bones. The patient was treated only with VAC chemotherapy and is able to walk normally.
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Affiliation(s)
- Haci Ahmet Demir
- Department of Pediatric Oncology, Institute of Oncology, Hacettepe University, Ankara, Turkey.
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van Niekerk ML, Nel WA, Slavik T. Infantile fibrosarcoma of the ileum presenting with congenital bowel obstruction. J Pediatr Surg 2010; 45:461-2. [PMID: 20152376 DOI: 10.1016/j.jpedsurg.2009.10.092] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/08/2009] [Revised: 10/30/2009] [Accepted: 10/30/2009] [Indexed: 10/19/2022]
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