Fibrous hamartoma of infancy (FHI) of the parotid region in a 3-year-old female presenting as a huge parapharyngeal tumor: A very rare case presentation

Introduction: Fibrous hamartoma of infancy (FHI) is a rare, benign tumor arising from the lower dermis and subcutaneous tissue. It usually occurs in children below two years of age and is often misdiagnosed as being of malignant nature. It most commonly effects the lower extremities, very rarely involves the head and neck region, and is commonly found in males. Microscopically, it is a poorly circumscribed and non-capsulated tumor comprising of interlacing fascicles of pale eosinophilic myofibroblasts and stellate shaped fibroblasts with island of mature adipocytes. Case Report: We report a very rare case of FHI of parotid gland in a 3-year-old female child, posing a diagnostic difficulty for management. The site, size, and age of presentation of the tumor were unique. This tumor is common in males but our case was a female child. Our patient presented with involvement of the parotid, submandibular and upper neck area with a huge size of around 7 × 8 cm which was causing mild swallowing difficulty due to intraoral swelling in the child. Cytopathology from the lesion demonstrated spindle cell lesion, the differential diagnosis of which is often malignant in pediatric age group. We took a biopsy for confirmatory diagnosis and after histopathological diagnosis of FHI proceeded with complete surgical excision. Conclusion: Treatment of choice for these benign tumors is complete surgical excision, with excellent prognosis.