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Inset: Detailed image of the lesions on the thigh.</p>" ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "J. Alonso-González, M.T. Rodríguez-Granados, J. Toribio" "autores" => array:3 [ 0 => array:2 [ "nombre" => "J." "apellidos" => "Alonso-González" ] 1 => array:2 [ "nombre" => "M.T." "apellidos" => "Rodríguez-Granados" ] 2 => array:2 [ "nombre" => "J." 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"apellidos" => "Navarro-Hervas" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "aff0010" ] ] ] ] "afiliaciones" => array:2 [ 0 => array:3 [ "entidad" => "Servicio de Dermatología, Hospital Universitario de La Ribera, Alzira, Valencia, Spain" "etiqueta" => "a" "identificador" => "aff0005" ] 1 => array:3 [ "entidad" => "Servicio de Anatomía Patológica, Hospital Universitario de La Ribera, Alzira, Valencia, Spain" "etiqueta" => "b" "identificador" => "aff0010" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "⁎" "correspondencia" => "Corresponding Author." ] ] ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Tumor congénito ulcerado" ] ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:7 [ "identificador" => "fig0010" "etiqueta" => "Figure 2" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr2.jpeg" "Alto" => 631 "Ancho" => 900 "Tamanyo" => 163583 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">A, hematoxylin-eosin, original magnification ×10. B, hematoxylin-eosin, original magnification ×20. C, smooth muscle actin, original magnification ×10. D. Desmin, original magnification ×10.</p>" ] ] ] "textoCompleto" => "<span class="elsevierStyleSections"><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0005">Medical History</span><p id="par0005" class="elsevierStylePara elsevierViewall">A newborn girl was evaluated in our dermatology department for a congenital tumor in the right frontal region. She is the first child of healthy nonconsanguineous parents and was born following a full-term normal pregnancy and a normal delivery. The mother had no history of infection, drug use, or family history of skin disease.</p></span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0010">Physical Examination</span><p id="par0010" class="elsevierStylePara elsevierViewall">The patient presented an erythematous nodule with a vascular appearance. The nodule was ulcerated, of fibrous consistency, attached to the deeper layers, and measured approximately 3<span class="elsevierStyleHsp" style=""></span>cm in diameter (<a class="elsevierStyleCrossRef" href="#fig0005">Fig. 1</a>). No other similar skin lesions or palpable evidence of visceromegaly were observed.</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia></span><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0015">Histology</span><p id="par0015" class="elsevierStylePara elsevierViewall">Histology revealed superficial and deep dermal proliferation of spindle cells with no nuclear atypia. The spindle cells were arranged in cellular bands and fascicles (<a class="elsevierStyleCrossRef" href="#fig0010">Fig. 2</a>, A and B). Immunohistochemical techniques showed that the cells were positive for vimentin and smooth muscle α-actin (<a class="elsevierStyleCrossRef" href="#fig0010">Fig. 2C</a>) and negative for S100, myoglobin, cytokeratins, and desmin (<a class="elsevierStyleCrossRef" href="#fig0010">Fig. 2D</a>).</p><elsevierMultimedia ident="fig0010"></elsevierMultimedia></span><span id="sec0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0020">Additional Tests</span><p id="par0020" class="elsevierStylePara elsevierViewall">Bone series, abdominal ultrasound, and computed tomography revealed no signs of bone or visceral involvement.</p><p id="par0025" class="elsevierStylePara elsevierViewall">What Is Your Diagnosis?</p></span><span id="sec0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0025">Diagnosis</span><p id="par0030" class="elsevierStylePara elsevierViewall">Solitary infantile myofibromatosis.</p></span><span id="sec0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0030">Clinical Course and Treatment</span><p id="par0035" class="elsevierStylePara elsevierViewall">A decision was made to adopt a wait-and-see approach and perform periodic examinations. At the time of writing, the tumor continues to regress.</p></span><span id="sec0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0035">Comment</span><p id="par0040" class="elsevierStylePara elsevierViewall">Infantile myofibromatosis (IM) is a congenital mesenchymal disorder characterized by the presence of solitary or multiple myofibroblastic tumors which may affect the skin, soft tissues, bones, or internal organs.<a class="elsevierStyleCrossRef" href="#bib0005"><span class="elsevierStyleSup">1</span></a> This disorder was first described by Stout in 1954, although the currently used term was introduced in 1981 by Chung and Enzinger.<a class="elsevierStyleCrossRef" href="#bib0010"><span class="elsevierStyleSup">2</span></a> Though considered a rare disease, IM is nonetheless the most common fibrous tumor in infancy. These tumors habitually present between birth and 2 years of age, and lesions limited to the skin tend to have a good prognosis with high rates of spontaneous regression.</p><p id="par0045" class="elsevierStylePara elsevierViewall">Although most cases of IM are sporadic, a familial form has been described in monozygotic twins and in successive generations; it is possible that such cases may be attributable to an autosomal dominant inheritance pattern with variable penetrance.<a class="elsevierStyleCrossRef" href="#bib0015"><span class="elsevierStyleSup">3</span></a></p><p id="par0050" class="elsevierStylePara elsevierViewall">The etiology is unknown. Yousefi et al.<a class="elsevierStyleCrossRef" href="#bib0020"><span class="elsevierStyleSup">4</span></a> hypothesized that mesenchymal stem cells transferred during pregnancy may participate in tissue remodeling in the fetus, although in a study of tissue samples from 4 newborns with solitary or multiple IM, the authors demonstrated that tumor cells were not derived from maternal chimeric cells. On the other hand, the level of maternal estrogen does appear to influence the development of these tumors, as spontaneous regression occurs after delivery, when the exposure to estrogens has ceased.<a class="elsevierStyleCrossRefs" href="#bib0005"><span class="elsevierStyleSup">1,5</span></a></p><p id="par0055" class="elsevierStylePara elsevierViewall">There are 3 patterns of clinical presentation: solitary IM (a single lesion affecting the skin and/or muscles in the head, neck, or trunk; this pattern is the most common one in children, representing 75% of all cases); multicentric IM without visceral involvement (multiple lesions limited to the skin and muscles); and multicentric IM with visceral or systemic involvement (multiple lesions not only of the skin and/or muscles, but also of the bones, lungs, heart, and gastrointestinal tract).<a class="elsevierStyleCrossRef" href="#bib0005"><span class="elsevierStyleSup">1</span></a></p><p id="par0060" class="elsevierStylePara elsevierViewall">The clinical presentation of cutaneous tumors in IM is heterogeneous: these lesions appear as a plaque, nodule, or mass; are solitary or multiple; measure from 0.5 to 5<span class="elsevierStyleHsp" style=""></span>cm; are not painful; have a firm consistency; rarely ulcerate or bleed; and may have a keloid or vascular appearance.</p><p id="par0065" class="elsevierStylePara elsevierViewall">Biopsy of lesions that are accessible—as is usually the case with skin lesions—is required to confirm the diagnosis. IM skin tumors are well-defined dermal nodules exhibiting a biphasic growth pattern. A high number of spindle cells arranged in fascicles (smooth muscle–like fascicles) can be seen on the periphery of the tumor; these cells show no nuclear abnormalities, although there may be occasional mitotic figures, and they express smooth muscle α-actin and vimentin and are negative for S100. The central area contains vascular structures with irregular lumens and a hemangiopericytic pattern.<a class="elsevierStyleCrossRef" href="#bib0030"><span class="elsevierStyleSup">6</span></a></p><p id="par0070" class="elsevierStylePara elsevierViewall">Differential diagnosis in cases of isolated lesions includes deep hemangiomas, neurofibroma, leiomyoma, sarcoma, and neuroblastoma metastasis. From a histologic point of view, a distinction must be made between IM and congenital fibrosarcoma and hemangiopericytoma.<a class="elsevierStyleCrossRefs" href="#bib0015"><span class="elsevierStyleSup">3,5</span></a></p><p id="par0075" class="elsevierStylePara elsevierViewall">Prognosis for solitary and multiple lesions that do not affect internal organs is excellent, with spontaneous remission occurring in 1 to 2 years, probably related to massive apoptosis.<a class="elsevierStyleCrossRef" href="#bib0005"><span class="elsevierStyleSup">1</span></a> A conservative wait-and-see approach is appropriate for these types of IM. On the other hand, IM with visceral involvement is serious and associated mortality is high, especially when gastrointestinal and cardiorespiratory systems are compromised.<a class="elsevierStyleCrossRef" href="#bib0030"><span class="elsevierStyleSup">6</span></a> Patients with visceral disease therefore require surgical and/or medical treatment (e.g., radiation therapy or chemotherapy with vincristine, actinomycin D, and cyclophosphamide) in addition to palliative care.</p></span></span>" "textoCompletoSecciones" => array:1 [ "secciones" => array:8 [ 0 => array:2 [ "identificador" => "sec0005" "titulo" => "Medical History" ] 1 => array:2 [ "identificador" => "sec0010" "titulo" => "Physical Examination" ] 2 => array:2 [ "identificador" => "sec0015" "titulo" => "Histology" ] 3 => array:2 [ "identificador" => "sec0020" "titulo" => "Additional Tests" ] 4 => array:2 [ "identificador" => "sec0025" "titulo" => "Diagnosis" ] 5 => array:2 [ "identificador" => "sec0030" "titulo" => "Clinical Course and Treatment" ] 6 => array:2 [ "identificador" => "sec0035" "titulo" => "Comment" ] 7 => array:1 [ "titulo" => "References" ] ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "NotaPie" => array:1 [ 0 => array:2 [ "etiqueta" => "☆" "nota" => "<p class="elsevierStyleNotepara" id="npar0005">Please cite this article as: Martí-Fajardo N, et al. Tumor congénito ulcerado. Actas Dermosifiliogr. 2013;104:525–6.</p>" ] ] "multimedia" => array:2 [ 0 => array:6 [ "identificador" => "fig0005" "etiqueta" => "Figure 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 475 "Ancho" => 501 "Tamanyo" => 35985 ] ] ] 1 => array:7 [ "identificador" => "fig0010" "etiqueta" => "Figure 2" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr2.jpeg" "Alto" => 631 "Ancho" => 900 "Tamanyo" => 163583 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">A, hematoxylin-eosin, original magnification ×10. B, hematoxylin-eosin, original magnification ×20. C, smooth muscle actin, original magnification ×10. D. Desmin, original magnification ×10.</p>" ] ] ] "bibliografia" => array:2 [ "titulo" => "References" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0005" "bibliografiaReferencia" => array:6 [ 0 => array:3 [ "identificador" => "bib0005" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Infantile myofibromatosis: report of nine patients" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:6 [ 0 => "M. Larralde" 1 => "M.V. Hoffner" 2 => "P. Boggio" 3 => "M.E. Abad" 4 => "P.C. Luna" 5 => "N. Correa" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1111/j.1525-1470.2009.01073.x" "Revista" => array:6 [ "tituloSerie" => "Pediatr Dermatol" "fecha" => "2010" "volumen" => "27" "paginaInicial" => "29" "paginaFinal" => "33" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/20199406" "web" => "Medline" ] ] ] ] ] ] ] ] 1 => array:3 [ "identificador" => "bib0010" "etiqueta" => "2" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "A case of congenital multiple myofibromatosis developing in an infant" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "B.J. Schrodt" 1 => "J.P. 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año/Mes | Html | Total | |
---|---|---|---|
2024 Noviembre | 14 | 13 | 27 |
2024 Octubre | 73 | 44 | 117 |
2024 Septiembre | 88 | 30 | 118 |
2024 Agosto | 100 | 74 | 174 |
2024 Julio | 76 | 40 | 116 |
2024 Junio | 83 | 37 | 120 |
2024 Mayo | 60 | 37 | 97 |
2024 Abril | 81 | 30 | 111 |
2024 Marzo | 69 | 31 | 100 |
2024 Febrero | 68 | 33 | 101 |
2024 Enero | 64 | 33 | 97 |
2023 Diciembre | 60 | 17 | 77 |
2023 Noviembre | 68 | 24 | 92 |
2023 Octubre | 75 | 20 | 95 |
2023 Septiembre | 56 | 29 | 85 |
2023 Agosto | 49 | 27 | 76 |
2023 Julio | 82 | 39 | 121 |
2023 Junio | 48 | 20 | 68 |
2023 Mayo | 85 | 31 | 116 |
2023 Abril | 64 | 21 | 85 |
2023 Marzo | 60 | 29 | 89 |
2023 Febrero | 54 | 17 | 71 |
2023 Enero | 35 | 21 | 56 |
2022 Diciembre | 44 | 30 | 74 |
2022 Noviembre | 44 | 22 | 66 |
2022 Octubre | 35 | 16 | 51 |
2022 Septiembre | 27 | 38 | 65 |
2022 Agosto | 17 | 26 | 43 |
2022 Julio | 31 | 31 | 62 |
2022 Junio | 29 | 21 | 50 |
2022 Mayo | 47 | 41 | 88 |
2022 Abril | 43 | 30 | 73 |
2022 Marzo | 53 | 56 | 109 |
2022 Febrero | 40 | 26 | 66 |
2022 Enero | 35 | 39 | 74 |
2021 Diciembre | 35 | 34 | 69 |
2021 Noviembre | 44 | 39 | 83 |
2021 Octubre | 38 | 64 | 102 |
2021 Septiembre | 31 | 38 | 69 |
2021 Agosto | 42 | 29 | 71 |
2021 Julio | 27 | 34 | 61 |
2021 Junio | 34 | 37 | 71 |
2021 Mayo | 34 | 40 | 74 |
2021 Abril | 73 | 44 | 117 |
2021 Marzo | 68 | 51 | 119 |
2021 Febrero | 58 | 36 | 94 |
2021 Enero | 36 | 29 | 65 |
2020 Diciembre | 34 | 31 | 65 |
2020 Noviembre | 31 | 23 | 54 |
2020 Octubre | 38 | 18 | 56 |
2020 Septiembre | 36 | 20 | 56 |
2020 Agosto | 28 | 23 | 51 |
2020 Julio | 30 | 16 | 46 |
2020 Junio | 22 | 26 | 48 |
2020 Mayo | 31 | 16 | 47 |
2020 Abril | 28 | 22 | 50 |
2020 Marzo | 28 | 19 | 47 |
2020 Febrero | 2 | 5 | 7 |
2020 Enero | 4 | 1 | 5 |
2019 Diciembre | 8 | 1 | 9 |
2019 Noviembre | 4 | 0 | 4 |
2019 Septiembre | 12 | 0 | 12 |
2019 Agosto | 4 | 6 | 10 |
2019 Julio | 4 | 5 | 9 |
2019 Junio | 3 | 4 | 7 |
2019 Mayo | 4 | 6 | 10 |
2019 Abril | 2 | 7 | 9 |
2019 Marzo | 2 | 8 | 10 |
2019 Febrero | 2 | 2 | 4 |
2019 Enero | 1 | 0 | 1 |
2018 Diciembre | 0 | 8 | 8 |
2018 Noviembre | 1 | 0 | 1 |
2018 Octubre | 2 | 0 | 2 |
2018 Septiembre | 3 | 0 | 3 |
2018 Marzo | 1 | 0 | 1 |
2018 Febrero | 39 | 3 | 42 |
2018 Enero | 56 | 4 | 60 |
2017 Diciembre | 51 | 4 | 55 |
2017 Noviembre | 32 | 2 | 34 |
2017 Octubre | 41 | 7 | 48 |
2017 Septiembre | 34 | 4 | 38 |
2017 Agosto | 32 | 8 | 40 |
2017 Julio | 48 | 7 | 55 |
2017 Junio | 46 | 5 | 51 |
2017 Mayo | 42 | 3 | 45 |
2017 Abril | 37 | 7 | 44 |
2017 Marzo | 50 | 5 | 55 |
2017 Febrero | 146 | 4 | 150 |
2017 Enero | 36 | 5 | 41 |
2016 Diciembre | 59 | 6 | 65 |
2016 Noviembre | 77 | 6 | 83 |
2016 Octubre | 102 | 12 | 114 |
2016 Septiembre | 180 | 6 | 186 |
2016 Agosto | 102 | 7 | 109 |
2016 Julio | 44 | 7 | 51 |
2016 Junio | 8 | 7 | 15 |
2016 Mayo | 5 | 0 | 5 |
2016 Abril | 4 | 1 | 5 |
2016 Marzo | 4 | 0 | 4 |
2016 Febrero | 4 | 1 | 5 |
2016 Enero | 10 | 1 | 11 |
2015 Diciembre | 3 | 0 | 3 |
2015 Noviembre | 19 | 1 | 20 |
2015 Octubre | 20 | 3 | 23 |
2015 Septiembre | 8 | 1 | 9 |
2015 Agosto | 13 | 2 | 15 |
2015 Julio | 67 | 11 | 78 |
2015 Junio | 33 | 3 | 36 |
2015 Mayo | 41 | 3 | 44 |
2015 Abril | 36 | 3 | 39 |
2015 Marzo | 25 | 4 | 29 |
2015 Febrero | 48 | 3 | 51 |
2015 Enero | 33 | 1 | 34 |
2014 Diciembre | 30 | 3 | 33 |
2014 Noviembre | 25 | 6 | 31 |
2014 Octubre | 31 | 3 | 34 |
2014 Septiembre | 32 | 2 | 34 |
2014 Agosto | 26 | 4 | 30 |
2014 Julio | 27 | 5 | 32 |
2014 Junio | 42 | 2 | 44 |
2014 Mayo | 41 | 7 | 48 |
2014 Abril | 40 | 7 | 47 |
2014 Marzo | 41 | 7 | 48 |
2014 Febrero | 29 | 7 | 36 |
2014 Enero | 30 | 11 | 41 |
2013 Diciembre | 19 | 5 | 24 |
2013 Noviembre | 29 | 2 | 31 |
2013 Octubre | 8 | 2 | 10 |
2013 Septiembre | 3 | 4 | 7 |
2013 Agosto | 2 | 4 | 6 |
2013 Julio | 5 | 2 | 7 |