再発により2回の手術を要した乳幼児指趾線維腫症（infantile digital fibromatosis）の1例

Surgical Treatment for Recurred Infantile Digital Fibromatosis: A Case Report

はじめに

　乳幼児指趾線維腫症（infantile digital fibromatosis：以下，IDF）は，乳幼児の指趾に発生する多発性で術後再発率が高いことを特徴とする比較的まれな線維性腫瘍である 1）～3）。3～4歳ころまでに自然消退するとされているが，明確な治療のガイドラインはなく，切除すべきか経過観察すべきか判断に迷うことが多い。

　今回われわれは，乳児の足趾に生じ，初回の手術後に再発し，2回目の手術で治癒した症例を経験したので，文献的考察を加えて報告する。

　A variety of treatment options are available for infantile digital fibromatosis (IDF), a relatively rare benign tumor that occurs on the digits of infants and children, including observation, the use of a topical corticosteroid, and surgical resection. We report the case of a 2-year-old boy with a peripheral mass on his left footʼs little toe. An excisional biopsy was performed for its diagnosis, and the postoperative histopathological diagnosis was IDF. The tumor recurred after the primary surgery and was resistant to a topical injection of corticosteroid therapy. MRI showed a T1 and T2 low-intensity lesion that indicated a fibrous tumor such as IDF. A secondary wide resection with a detached dorsal cortex of the digital phalangeal bone was performed, and the toe healed without any recurrence.

　Although observation is one of the major treatment options for an IDF, the pathologic findings are essential for the differential diagnosis. Surgical resection under general anesthesia is fully acceptable for the management of these tumors in infants or children. To avoid recurrence, further investigations of the optimal resection margin for this benign tumor are required.