Testicular Myofibroma in Children: A Case Report and Review of the Literature

A rare case of cervical myofibroma in an infant: A case report

INTRODUCTION

A solitary infantile myofibroma tumor arises as a hard, painless cutaneous or subcutaneous nodule and is defined as an uncommon soft tissue neoplasm that is usually seen in childhood.

CASE PRESENTATION

A nine-month-old female infant presented with a solid mass that appeared one month ago. The mass gradually increased in size within the right posterior triangle of the neck, without any local or systemic accompanying symptoms. Laboratory tests were normal. Ultrasonography revealed a homogeneous tissue mass measuring 1.5 × 3 cm, with blood flow within it. Multislice CT scan accurately localized the isolated tumor. The mass was surgically excised and found within the sternocleidomastoid muscle, without any adhesions to adjacent tissues. Histological examination of the tumor and immunohistochemical tests confirmed infantile myofibroma.

CLINICAL DISCUSSION

IM is one of the most common soft tissue tumors in children and mainly consists of myofibroblasts. 90 % of IM cases are diagnosed before the age of two years. Possible therapeutic measures for this tumor include conservative management, surgical resection, chemotherapy, radiation therapy, and steroid injections into the tumor. Surgical removal of the tumor is often performed, and if it is single and completely removed, the prognosis is good with a recurrence rate of less than 10 %.

CONCLUSION

Infantile myofibroma is considered a benign tumor, but it may be fatal in some cases. Each case is treated individually according to the number (single or multicentric), size, location, symptoms, and visceral involvement. Surgical resection remains the therapeutic procedure of choice in most cases.

Imaging of Pediatric Testicular and Para-Testicular Tumors: A Pictural Review

Pre- and post-pubertal testicular tumors are two distinct entities in terms of epidemiology, diagnosis and treatment. Most pre-pubertal tumors are benign; the most frequent are teratomas, and the most common malignant tumors are yolk-sac tumors. Post-pubertal tumors are similar to those found in adults and are more likely to be malignant. Imaging plays a pivotal role in the diagnosis, staging and follow-up. The appearance on ultrasonography (US) is especially helpful to differentiate benign lesions that could be candidates for testis-sparing surgery from malignant ones that require radical orchidectomy. Some specific imaging patterns are described for benign lesions: epidermoid cysts, mature cystic teratomas and Leydig-cell tumors. Benign tumors tend to be well-circumscribed, with decreased Doppler flow on US, but malignancy should be suspected when US shows an inhomogeneous, not-well-described lesion with internal blood flow. Imaging features should always be interpreted in combination with clinical and biological data including serum levels of tumor markers and even intra-operative frozen sections in case of conservative surgery to raise any concerns of malignity. This review provides an overview of imaging features of the most frequent testicular and para-testicular tumor types in children and the value of imaging in disease staging and monitoring children with testicular tumors or risk factors for testicular tumors.