An Algorithmic Approach to the Management of Infantile Digital Fibromatosis

Review of Literature and a Case Report

Elizabeth H. Eypper, MD; Johnson C. Lee, MD; Ashley J. Tarasen, MD; Maxene H. Weinberg, BS; Oluwaseun A. Adetayo, MD


ePlasty. 2018;18(e19) 

In This Article

Management Algorithm

The authors propose a management algorithm for patients diagnosed with IDF. When a nodular lesion clinically consistent with IDF is discovered in a pediatric patient, the risks and benefits of operative management versus observation should be considered. None of the injection treatment methods have been explored in large studies, to date, leaving surgery as the most accepted treatment of symptomatic lesions. However, in the subset of asymptomatic patients with relatively large-sized tumors (>2×2 cm), preemptive treatment with intralesional triamcinolone or 5-fluorouracil should be considered when tolerated.[16] Given reports of spontaneous regression, asymptomatic IDF lesions can be conservatively managed with routine follow-ups and will therefore be the recommended approach to treatment in most cases. The proposed treatment algorithm is shown in Figure 3.

Figure 3.

Algorithm for the management of patients diagnosed with infantile digital fibromatosis.

Infantile digital fibromatosis is a rare childhood disease of benign myofibroblast tumors occurring on both upper and lower digits. Nodules that are asymptomatic should be watched over time for spontaneous regression or may be treated with chemotherapeutic agents, steroids if they become large or unwieldy. Surgical treatments should be reserved for cases with structural or functional compromise to minimize trauma and the associated risk of recurrence.