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A three-month-old boy was admitted for a slowly progressing nodule in his right chin, first recognized at birth and recently accompanied by facial paralysis. It was found to be a soft tissue mass arising in subcutaneous tissue and extending deep into the temporal muscle, causing temporal bone erosion without infiltrating the dura. Initially interpreted as mesenchymal chondrosarcoma, combined chemotherapy (PULSE-VAC) was given. Eighteen months later an additional nodule developed In the paraspinal skin. Evaluation of both lesions showed vimentin and α-smooth-muscle-action positivity. As the final diagnosis was multicenlric infantile myofibromatosis, the child was followed up without therapy. Thirty months later, multiple osteolytic lesions appeared on the skull and long bones of the extremities. Some lesions remained stable and some regressed during two years of follow-up.

The aim of this study was to investigate the relationship between Tc-99m-sestamibi accumulation in tumors and response to chemotherapy in children with untreated malignant lymphomas. Methods: Twenty-four children with malignant lymphoma (16 with Hodgkin's disease and 8 with non-Hodgkin's lymphoma) were studied with Tl-201 and then with Tc-99m-sestamibi scintigraphy before any therapeutic intervention. Visual and quantitative interpretation of Tl-201 and Tc-99m-sestamibi scans were performed. Visual uptake scores greater than or equal to 2+ were considered positive studies for Tl-201, and Tc-99m-sestamibi scintigraphy. Remission rates were evaluated at the end of induction therapy; patients were then followed clinically for 1-2 yr. Results: All 17 patients who had positive (99mT)c-sestamibi scans subsequently had a complete response to chemotherapy; all seven patients who had negative Tc-99m-sestamibi scans subsequently had partial or no response to chemotherapy, irrespective of the lymphoma type. The mean tumor-to-background ratios of patients with complete response and with partial or no response were 1.395 +/- 0.2 and 1.031 +/- 0.05 (p = 0.0002), respectively. Thallium-201 scintigraphy results were not related to the response to chemotherapy. Conclusion: Technetium-99m-sestamibi scintigraphy can provide information predicting the response to chemotherapy in patients with malignant lymphoma.