RT Journal
A1 Levkoff AH, Maize JC, Feingold M
T1 PIcture of the month
JF American Journal of Diseases of Children
JO American Journal of Diseases of Children
YR 1989
FD August 1
VO 143
IS 8
SP 963
OP 964
DO 10.1001/archpedi.1989.02150200123031
UL http://dx.doi.org/10.1001/archpedi.1989.02150200123031
AB Denouement and Discussion 
    Congenital rhabdomyomatous mesenchymal hamartoma of the skin, to our knowledge, has been described once previously as a single pedunculated appendage on the chin of a new-born. In that case, the appendage had an abnormal arrangement of dermal mesenchymal elements, with a prominence of skeletal muscle. In the patient shown herein, the connective-tissue core of the pulp contained adipose cells and striated muscle bundles that were oriented primarily parallel to the long axis. The epidermis was slightly hyperplastic and under higher magnification demonstrated striated muscle bundles. Pathologically, it was characterized as a hamartoma because of the abnormal mixture of normal cells (ie, striated muscle, mesenchyme, and skin) in an appropriate area, the face muscles of expression.Other than a very unusual appearance, the striking feature was the random contractile movements of the appendages, giving a snakelike appearance. Computed tomographic scan revealed no involvement of