New Born and Infant Soft Tissue Sarcomas

Sarcomas occurring in children under 1 year old account for 8% of all pediatric soft tissue sarcomas. The clinical aspect is not specific and the imaging exams have many pitfalls making the precise diagnosis often difficult. At this age, main sarcomas are infantile fibrosarcomas and rhabdoid tumors but rhabdomyosarcomas or undifferentiated sarcoma can also occur. Infantile fibrosarcoma has a favorable prognosis and conservative strategy is recommended. At the opposite, rhabdoid tumor is an aggressive tumor that needs intensive multimodal therapeutic strategy to try to increase prognosis. Infantile rhabdomyosarcomas and undifferentiated sarcomas are nowadays better characterized by a systematic analysis of their molecular biology. Strategy should take into account the type of sarcoma, but also the age and the medical condition of the young patient. Overall, surgery is a cornerstone of therapy, and chemotherapy should be adapted to the immature organs when radiotherapy should be avoided as possible due to their potential late consequences in infants. Furthermore, in some very extensive aggressive diseases ethical considerations should be taken into account and medical decisions must strongly consider parents’ opinion after clear information.