Primitive spindle cell neoplasm of ileum with extensive heterotopic cartilage, presenting as acute abdomen in a 6-day-old neonate

Ali Nael, William W. Wu, Lisa Shane, Nagesh Rao, Theodore Zwerdling

Research output: Contribution to journalArticle

Abstract

Neonatal intestinal masses with spindle cell morphology have broad differential diagnoses and require a multidisciplinary approach to make the final diagnosis. Spindle cell masses with heterotopic cartilage in the gastrointestinal tract are very rare, and, to our knowledge, have not previously been reported in the neonate. Here we present a case of intestinal primitive spindle cell neoplasm with extensive heterotopic cartilage that manifested initially as acute abdomen in a 6-day-old term infant. Plain radiography demonstrated pneumoperitoneum, prompting diagnostic laparotomy that identified a perforated mass involving the midileum. Histologic and immunohistochemical examination demonstrated an infiltrative spindle cell tumor most compatible with infantile fibrosarcoma (IFS) by a process of exclusion, with nodules of mature heterotopic cartilage. Additional staging studies did not reveal any evidence of residual or metastatic disease. Recognition of this rare variant of IFS will aid in differentiation from other neonatal intestinal mesenchymal tumors.

Original languageEnglish (US)
Pages (from-to)338-344
Number of pages7
JournalPediatric and Developmental Pathology
Volume19
Issue number4
DOIs
StatePublished - Jul 1 2016
Externally publishedYes

Keywords

  • ETV6 gene rearrangement
  • Heterotopic cartilage
  • Infantile fibrosarcoma
  • Mesenchymal tumors
  • Primitive spindle cell neoplasm

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Pathology and Forensic Medicine
  • Medicine(all)

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