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1</a>B&#41;&#46;</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><p id="par0010" class="elsevierStylePara elsevierViewall">Magnetic resonance imaging &#40;MRI&#41; and magnetic resonance angiography &#40;MRA&#41; disclosed a well-vascularized solid mass&#44; with the involvement of the underlying muscles and extending to the anterior aspect of the foot&#46; Diffuse contrast enhancement was observed throughout the lesion&#44; with no signs of arteriovenous shunts or a cluster of tortuous vessels &#40;nidus&#41;&#44; thus ruling out the diagnosis of a vascular tumor&#44; including kaposiform hemangioendothelioma &#40;<a class="elsevierStyleCrossRef" href="#fig0010">Figs&#46; 2</a>A and 2B&#41;&#46; A second biopsy was performed&#44; revealing a hypercellular fusiform tumor&#46; Immunohistochemistry was positive for vimentin and negative for CD31&#44; CD34&#44; factor VIII&#44; desmin&#44; MyoD1&#44; myogenin&#44; CD99 and EMA&#44; indicating the diagnosis of congenital infantile fibrosarcoma &#40;CIF&#41;&#46;</p><elsevierMultimedia ident="fig0010"></elsevierMultimedia><p id="par0015" class="elsevierStylePara elsevierViewall">The patient was submitted to neoadjuvant chemotherapy &#40;vincristine&#44; actinomycin-D and cyclophosphamide&#41; to reduce tumor size &#40;<a class="elsevierStyleCrossRef" href="#fig0005">Fig&#46; 1</a>C&#41;&#44; followed by amputation of the foot&#46; There are no signs of recurrence or metastasis at five years of follow-up&#46;</p><p id="par0020" class="elsevierStylePara elsevierViewall">CIF is a rare malignant tumor of childhood&#59; however&#44; it is the most common soft tissue sarcoma in children under one year of age&#46;<a class="elsevierStyleCrossRef" href="#bib0005"><span class="elsevierStyleSup">1</span></a> This highly vascularized congenital tumor is difficult to clinically differentiate from vascular tumors or malformations&#46; It may be present at birth or develop during the first five years&#44; with approximately 80&#37; of cases diagnosed during the first year of life&#46;<a class="elsevierStyleCrossRef" href="#bib0010"><span class="elsevierStyleSup">2</span></a></p><p id="par0025" class="elsevierStylePara elsevierViewall">Fibrosarcomas are malignant neoplasias composed of mesenchymal fibroblasts&#46; The infantile variant shares histopathological characteristics with adult fibrosarcoma but has a better prognosis&#46; Although local recurrences are common&#44; the rate of CIF metastasis is less than 10&#37; and the ten-year survival rate is up to 90&#37;&#46;<a class="elsevierStyleCrossRef" href="#bib0015"><span class="elsevierStyleSup">3</span></a> The extremities are more commonly affected and lesions located on the trunk&#44; head and neck are less frequent&#44; although they are more aggressive&#46;<a class="elsevierStyleCrossRefs" href="#bib0005"><span class="elsevierStyleSup">1&#44;4</span></a> Due to the risk of local recurrence&#44; extensive surgical resection is recommended&#46; Surgery alone shows recurrence rates of 17&#37; to 40&#37;&#46; Neoadjuvant chemotherapy reduces the risk of local recurrence and metastases&#46;<a class="elsevierStyleCrossRefs" href="#bib0010"><span class="elsevierStyleSup">2&#44;3&#44;5</span></a></p><p id="par0030" class="elsevierStylePara elsevierViewall">The histopathological findings of CIF include the proliferation of dense fusiform cells and vascularized areas&#46; Immunohistochemistry is positive for vimentin and&#44; in some cases&#44; for desmin&#44; smooth muscle actin&#44; and cytokeratin&#46;<a class="elsevierStyleCrossRef" href="#bib0020"><span class="elsevierStyleSup">4</span></a> CIF is characterized in up to 85&#37; of cases by a specific t&#40;12&#59;15&#41; &#40;p13&#58;q25&#41; chromosomal translocation encoding an ETV6-NTRK3 gene fusion&#46;<a class="elsevierStyleCrossRefs" href="#bib0005"><span class="elsevierStyleSup">1&#44;3&#8211;5</span></a></p><p id="par0035" class="elsevierStylePara elsevierViewall">The diagnosis of CIF should always be considered in the presence of a congenital&#44; spherical&#44; bleeding extremity tumor in children&#44; aiming to avoid treatment delays&#46;</p><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0005">Financial support</span><p id="par0040" class="elsevierStylePara elsevierViewall">None declared&#46;</p></span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0010">Authors&#8217; contributions</span><p id="par0045" class="elsevierStylePara elsevierViewall">Luciana Baptista Pereira&#58; Design and planning of the study&#59; drafting and editing of the manuscript&#59; collection&#44; analysis&#44; and interpretation of data&#59; critical review of the manuscript&#59; approval of the final version of the manuscript&#46;</p><p id="par0050" class="elsevierStylePara elsevierViewall">Jo&#227;o Renato Vianna Gontijo&#58; Critical review of the manuscript&#59; drafting and editing of the manuscript&#59; approval of the final version of the manuscript&#46;</p><p id="par0055" class="elsevierStylePara elsevierViewall">Marcelo de Mattos Garcia&#58; Critical review of the manuscript&#59; drafting and editing of the manuscript&#59; approval of the final version of the manuscript&#46;</p><p id="par0060" class="elsevierStylePara elsevierViewall">Karine Corr&#234;a Fonseca&#58; Critical review of the manuscript&#59; drafting and editing of the manuscript&#59; approval of the final version of the manuscript&#46;</p></span><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0015">Conflicts of interest</span><p id="par0065" class="elsevierStylePara elsevierViewall">None declared&#46;</p></span></span>"
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