When a Hemangioma is not a Hemangioma: Diagnostic Challenges in Infantile Soft Tissue Masses

Infantile fibrosarcoma’s are the most common soft tissue sarcomas in infants under the age of one, and also have an excellent survival rate. However, these tumors also have a propensity to grow rapidly, and as such, require prompt evaluation and intervention to avoid negative outcomes, such as increased local invasion, more extensive surgical resections or amputations, as well as the potential risk for distant spread. This case report describes the presentation of an infantile fibrosarcoma that was initially misdiagnosed as an infantile hemangioma. Two conditions that can present very similarly in both clinical and radiologic evaluation, but require very different treatment strategies. Through our case presentation, we aim to highlight the importance of vigilance and accuracy during diagnostic work-up to ensure swift intervention for patients with potentially sinister underlying diagnoses.