CORRECT DIAGNOSIS:

Infantile digital fibroma

DISCUSSION:

Infantile digital fibromas are also commonly referred to as recurring digital fibrous tumor of childhood and inclusion body fibromatosis. This is a benign, asymptomatic growth that appears on dorsolateral fingers or toes during the first year of life typically sparing the thumb and great toe. Most tumors spontaneously regress within 2-3 years. However, functional impairment or deformity of the digit may require earlier surgical intervention, although greater than 50% may recur.

TREATMENT:

The actual treatment for this patient: Due to the recurrence and rapid growth of the tumor, we referred our patient to an orthopedic hand surgeon for re-excision.

Other Treatment Options: Depending on the special circumstances and physical findings of each patient, the spectrum of treatment options include: reassurance and observation, wide-local excision, or even amputation in extenuating cases. However, the role of surgical intervention is controversial due to the high post-op recurrence rate (50%) and the potential for spontaneous resolution.

REFERENCES:

Bolognia, J. L., Jorizzo, J. L., et al. (2003). Fibrous proliferations of skin and tendons. In Dermatology (1st ed., p. 1872). Elsevier Limited.

Schachner, L. A., & Hansen, R. C. (2003). Fibroblastic and myofibroblastic tumors. In Pediatric dermatology (3rd ed., p. 869). Elsevier Limited.

Weedon, D. (2002). Tumors and tumor-like proliferations of fibrous and related tissues. In Skin pathology (2nd ed., p. 925). Elsevier Limited.

Elder, D., et al. (1997). Tumors of fibrous tissue involving the skin. In Lever’s histopathology of the skin (8th ed., pp. 869–870). Lippincott-Raven.

Hurwitz, S. (1993). Cutaneous tumors of childhood. In Clinical pediatric dermatology (2nd ed., pp. 229–230). W.B. Saunders.