Objective The purpose of this study was to highlight the imaging findings of infantile fibrosarcoma(IFS)on X-ray film,CT and MRI,to summarize the clinical characteristics and the factors causing misdiagnosis.Methods We retrospectively analyzed the Imaging characteristics of the patients with histologically confirmed IFS diagnosed in our hospi-tals from February 2014 to January 2022.The 11 patients included nine little boys and two little girls,aged from 4 days to 3 years and 8 months,with an average of(0.52±1.01)years.These cases were performed by the following radiological diag-nosis.Preoperative X-ray examination was performed in seven patients,plain and enhanced CT or MRI scans were performed in nine patients,three were three patients among of them received both plain and enhanced CT and MRI scans simultaneous-ly.Results Of the11 patients,six(6/11)tumors were located in the extremities,two(2/11)were in the chest wall,two(2/11)were in the abdominal and one(1/11)was in nasal cavity.eight lesions were showed in elliptic shaped and three were quasi-circular tumor.Most tumors of all cases were large,and that the maximum diameter line of lesions ranged from 22 mm to 120 mm,with an average of(69±30)mm.The main symptom for the first visit was local lump in nine patients,and ulceration in two of them.The other symptoms included abdominal distension in one case and nasal obstruction with repeated bleeding in one case.The main manifestations of X-ray were large and soft tissue-masses with slightly higher density.The main CT manifestations were soft tissue masses with slightly low density,and the boundary with adjacent muscle tissue was not clear.Enhanced scan showed uneven enhancement of lesions,including progressive enhancement and edge nodular en-hancement.The main MRI manifestations were isointensity or slightly hypointense on T1 WI,hyperintensity or slightly hyper-intense on T2WI.Enhanced scan showed uneven and obvious enhancement of the lesion.Among the 11 lesions,hemorrhage was seen in six,calcification was seen in two,cystic degeneration and necrosis was seen in nine,large empty flow vessels was seen in seven,adjacent bone compression,deformation,local bone absorption were observed in five.Among the 11 patients,six were misdiagnosed as Vasogenic tumor,one was misdiagnosed as teratoma,one diagnosed with muscular or neurogenic source tumor,three were not qualitative diagnosis.Conclusion The incidence of IFS is low and the specificity is not high,many cases of IFS are originally misdiagnosed by clinicians and radiologists.It is helpful for accurate diagnosis to com-prehensively understand and the imaging manifestations of IFS and analyze the causes of misdiagnosis.
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