Infantile digital fibromatosis

Infantile digital fibromatosis, also known as inclusion body fibromatosis or Reye tumor, is a rare benign fibrous tumor that occurs almost exclusively in infants and young children. The condition is characterized by the development of firm, smooth, dome-shaped nodules on the fingers and toes, typically sparing the thumbs and great toes. These nodules arise from myofibroblasts and are distinguished histologically by the presence of characteristic perinuclear eosinophilic cytoplasmic inclusion bodies composed of actin filaments. The tumors primarily affect the soft tissues of the digits, usually appearing on the dorsal or lateral surfaces of the fingers and toes. They are generally painless but can cause functional impairment, including limited joint mobility and digit deformity, depending on their size and location. The nodules may be present at birth or develop within the first few years of life, and multiple lesions may occur simultaneously or sequentially. The condition does not metastasize and is not associated with systemic disease. The natural history of infantile digital fibromatosis is notable for a tendency toward spontaneous regression over time, which has increasingly influenced management strategies. Treatment options include observation (watchful waiting), surgical excision, and intralesional corticosteroid injections. Surgical excision has historically been the primary treatment; however, recurrence rates following surgery are high, reported in up to 60% of cases. Given the benign nature and potential for spontaneous resolution, conservative management with observation is now often recommended as the first-line approach, reserving surgical intervention for cases with significant functional impairment or cosmetic concern.

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