Multiple Bone Lesions in an 8-Month-Old Child Presenting with Pathologic Fracture A Rare Case of Solely Osseous Multicentric Infantile Myofibromatosis J. McCammon, MD, C. Stefanovici, MD, FRCPC, R.K. Martin, MD, and P. Larouche, MD, FRCSC Investigation performed at the University of Manitoba, Winnipeg, Manitoba Abstract Case: An otherwise healthy 8-month-old boy presented with a pathologic fracture of the distal aspect of the radius. Further work-up demonstrated widespread osseous lesions of the axial and the appendicular skeleton with no soft-tissue or visceral involvement. Conclusion: Infantile myofibromatosis has a spectrum of severity that demands a careful and complete work-up. In rare cases such as the present one, it can manifest as multiple osseous lesions. The patient in the present case was managed conservatively, with no morbidity demonstrated at 1 year of follow-up. I nfantile myofibromatosis (IM) is one of the most common fibrous tumors of infancy and early childhood. This con- genital mesenchymal disorder may present with solitary or multiple tumors that may affect skin, soft tissues, bones, and viscera 1 . Based on the extent of involvement, 4 major categories have been described: solitary, multicentric with nonvisceral le- sions, multicentric with a single visceral lesion, and multicentric with multiple visceral lesions 2 . A good prognosis is expected in most cases, with spontaneous regression of tumors within a few years 1 . The exception is in cases with visceral involvement, in which prognosis is dependent on the amount of damage to the affected organ. Fig. 1-A Fig. 1-B Fig. 1-A Posteroanterior radiograph of the right wrist demonstrating a large lytic (lucent) lesion with a nondisplaced pathologic fracture. Fig. 1-B Lateral radiograph of the right wrist demonstrating a large lytic lesion with a nondisplaced pathologic fracture. Disclosure: The authors indicated that no external funding was received for any aspect of this work. The Disclosure of Potential Conflicts of Interest forms are provided with the online version of the article. 1 COPYRIGHT Ó 2016 BY THE J OURNAL OF BONE AND J OINT SURGERY,I NCORPORATED JBJS Case Connect 2016;6:e42 d http://dx.doi.org/10.2106/JBJS.CC.15.00221