“A Tomb in the Womb”—A Massive Congenital Soft Tissue Tumor on the Hand in a Neonate

Shruti Thakur, Raj Kumar, Vijay Thakur, Neeti Aggarwal

Abstract

Congenital soft tissue tumors are a poorly understood group of tumors because of their rarity and complexity. Most of them are benign vascular tumors with favorable outcomes. However, the malignant ones present with poor prognosis, due to delayed diagnosis and therapeutic challenges encountered while dealing with them (eg, age-adapted chemotherapy, radiotherapy, and radical surgery). The etiology of congenital tumors is poorly understood and differs from that of tumors presenting later in the pediatric or adult life.

We present a case of a neonate born with a massive soft tissue tumor of the left hand. The clinical picture and magnetic resonance imaging findings narrowed the differentials to rhabdomyosarcoma, extraosseous Ewing sarcoma, or fibrosarcoma. This case highlights the importance of early in utero detection of such tumors that may require special consideration during fetal delivery and perinatal management.