Plaque-like myofibroblastic tumor: report of a recurrent pediatric case and review of the literature.

Abstract

Plaque-like myofibroblastic tumor (PLMT) is an uncommon, frequently misdiagnosed dermal spindle cell neoplasm that primarily affects infants and young children. We present the case of a 2-year-old girl with a slowly growing scapular plaque that, following an initial misdiagnosis of dermatofibroma, demonstrated abrupt growth, pain, and local recurrence after excision. Definitive diagnosis was established via immunohistochemical analysis, which revealed strong, uniform positivity for smooth muscle actin (SMA) and negative expression of CD34, highlighting the myofibroblastic lineage of the lesion. This report emphasizes that PLMT, while benign, exhibits locally aggressive behavior and requires complete surgical excision with clear deep margins to ensure a favorable long-term prognosis.