Is it a hemangioma? A combined case report of soft tissue sarcomas mimicking infantile hemangioma

Infantile hemangiomas (IHs) are the most common infantile tumors. They are benign and often responsive to propranolol. IHs are difficult to distinguish from malignant soft tissue tumors like sarcomas. Sarcomas are rare mesenchymal tumors that mimic hemangiomas, delaying treatment and affecting outcomes. We report two instances in which female infants with sarcomas were initially misdiagnosed as hemangiomas. In the first case, propanolol was administered to a 1-month-old presenting with a left inguinal mass. Imaging revealed a hemangioma. Tumor growth necessitated a biopsy, revealing a sarcoma. In the second case, a 2-month-old presented with a rapid growing and ulcerating left-hand swelling and was misdiagnosed as a hemangioma. Imaging and biopsy revealed metastatic sarcoma. Both patients developed brain metastases and passed away. These cases highlight that IHs need to be re-evaluated when rapid growth or ulceration is encountered. Early detection is essential for optimal outcomes.