Prenatal ultrasound diagnosis of congenital infantile fibrosarcoma and congenital hemangioma: Three case reports

Table 1 Summary of the three cases

		Case 1	Case 2	Case 3
Age (yr)		31	29	32
History of gravida and para		G 1 P 0	G 1 P 0	G 2 P 1
Singleton/Twin		Singleton	Singleton	Twin
GA at diagnosis (wk + d)		28 + 0	23 + 1	28 + 3
Location		The left axilla to the left chest wall	The root of the right thigh	Thoracic and abdominal wall
Prenatal fetal ultrasound findings at diagnosis	Size (cm)	3.2 × 3.0	2.6 × 1.4	5.0 × 4.2
	Echoes	Heterogeneous	Heterogeneous	Heterogeneous
	Boundary	Clear	Clear	Clear
	Shape	Irregular	Irregular	Regular
	Blood flow (Adler)	Grade III	Grade I	Grade III
Prenatal management		None	None	At 33 + 0 wk, due to intrauterine fetal death on the affected side, dexamethasone was given to promote lung maturation of the contralateral fetus
GA at delivery (wk + d)		37 + 0	40 + 0	33 + 3
Mode of delivery		Caesarean section	Normal spontaneous vaginal delivery	Caesarean section
Apgar score				/
1 min		9	9
5 min		10	10
10 min		10	10
Postnatal physical examination: Restricted movement of affected limbs		Yes	Yes	/
Postnatal fetal ultrasound findings				/
Size (Compared to the last prenatal ultrasound)		Increase	Unchanged
Repeat ultrasound (growth trend in size in the short-term)		Yes	Yes
Blood flow (Adler)		Grade III	Grade III
Postnatal ultrasound-guided biopsy		Yes	Yes
Other postnatal imaging examinations		X-ray	MRI	/
Postnatal laboratory examination: Coagulation dysfunction		Yes	Yes	/
Postnatal management		Surgery + chemotherapy	Chemotherapy	/
Pathological results		CIF	CH	CH
Follow-up outcome (duration)		No recurrence (12 mo)	No recurrence (24 mo)	Death

GA: Gestational age; G: Gravida; P: Para; MRI: Magnetic resonance imaging; CIF: Congenital infantile fibrosarcoma; CH: Congenital hemangioma.

Table 2 Literature review of cases with both ultrasound findings and NTRK3 gene diagnosis of congenital infantile fibrosarcoma

Ref.	GA at diagnosis (wk)	Sex	Site	Size (cm)	Coagulopathy	Treatment	Outcome	GA at delivery (wk)	Modality of delivery	Birth weight (kg)	Prenatal ultrasound findings	Immunochemistry	ETV6/NTRK3 gene fusion detected	Affected organs or metastasis
Nonaka et al[7], 2004	19	Male	Back	6.1×2.2	-	-	-	29	Pregnancy terminated at 29 wk	1.4	Solid mass involving the soft tissue at the rightparaspinal area	Vim(+)	Yes	Liver and left adrenal gland
Al-Salem et al[4], 2011	-	Male	Sacrococcygeal	12.0×10.0	-	S	No recurrence during follow-up	40	Cesarean section	4.1	Not described in detail	Vim(+), Ki67(+)> 5%	Yes	Bone margin and skeletal muscle
Dumont et al[8], 2011	36	Male	Right leg	9.0×8.0	Hemorrhagic shock	S*	Died at day 8 of life	38	Cesarean section	3.3	Poorly vascularized	Vim(+)	Yes	-
Tsang et al[9], 2013	37	-	Right frontal	9.0×7.0	-	S	No recurrence during follow-up	37	Cesarean section	-	Not described in detail	Vim(+)	Yes	Skull
Kraneburg et al[10], 2013	36	Male	Left leg	11.8×9.3	Bleeding, anemia, hypovolemia	S*	No recurrence during follow-up	36	Vaginal delivery	2.1	Well-circumscribed, intracavitary, homogenous solid mass	-	Yes	-
Sıvrıkoz et al[11], 2020	24	Male	Anterior fetal neck and oropharyngeal	5.5×5.4	-	S+C	No recurrence during follow-up	36	Cesarean section	2.9	Hypervascular with irregular borders	Ki-67(+) 1%	Yes	Masseter muscle, parotid gland, thyroid gland
The present study, 2022	28	Male	Left axilla to the left chest wall	3.2×3.0	Consumptive coagulation dysfunction	S+C	No recurrence during follow-up	37	Cesarean section	2.6	Well-defined, heterogeneous with abundant blood flow	Ki-67 (+) 20%, SMA (+), CD34 (+) and CD31 (+)	Yes	Pectoralis and adjacent ribs

GA: Gestational age; S: Surgery; C: Chemotherapy; *: Amputation; vim: Vimentin; -: Not mentioned; SMA: Smooth muscle actin.