Imaging description

A four-month-old male infant presented with a soft tissue mass of his upper back. There was no evidence of pain or other symptoms. A CT scan revealed a soft tissue mass involving the left paraspinal soft tissues of the lower thoracic spine with peripheral enhancement and central low attenuation relative to muscle (Fig. 95.1a). Additional bony lesions were demonstrated involving the thoracic spine at multiple levels. An example of a lytic lesion involving the right posterior elements of the lower thoracic spine (Fig. 95.1b) demonstrated peripheral enhancement (Fig. 95.1c). On MRI, multiple enhancing lesions were seen involving multiple vertebral bodies with collapse of several vertebral bodies (Fig. 95.1d). In addition, a homogeneously enhancing mass was discovered involving the extradural spinal canal (Fig. 95.1e). Radiographs performed as part of a skeletal survey demonstrated multiple lytic lesions primarily involving the metaphyses (Fig. 95.1f, g). Infantile myofibromatosis was confirmed histologically.