Purpose or Case Report: Infantile myofibromatosis is rare. The generalized form affects the integument and musculoskeletal system as well as multiple visceral organs and can impair organ function, thus requiring prompt diagnosis and treatment at an early age. As a disease that presents before the age of two years, minimizing use of CT and MRI is imperative to reduce radiation and gadolinium contrast use, respectively.
We present a case of a neonate in whom multiple cutaneous and an appendiceal lesion raised the suspicion of infantile myofibromatosis. Multiple liver lesions were seen on gray-scale ultrasound. On contrast-enhanced ultrasound (CEUS), there were multiple, differently-enhancing liver lesions, a finding which was confirmed on MRI with hepatocyte specific contrast. These were all thought to represent myofibromas with complete involution following low dose chemotherapy.
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Conclusions: CEUS provides a uniquely accessible means to assess neonatal liver lesions. Whilst extremely rare, myofibromatosis should be considered in the setting of multiple, differently enhancing liver lesions on CEUS.