The patient was a 2-month-old premature infant who was twin A of a set from fraternal twin girls, and was born at 32 weeks of gestation age via Cesarean section to a 33-year-old gravida 2, para 0 woman who underwent an in vitro fertilization pregnancy for a bicornuate uterus. While in the neonatal intensive care unit (NICU), the baby was found to have multiple nodules on her abdomen, chest and extremities, the largest measuring 1.8 cm on greatest dimension. Head, thoracic, abdominal and pelvic magnetic resonance imaging revealed the nodules to be primarily in the skeletal muscle and subcutaneous tissue. In addition, a 5 mm metaphyseal enhancing lesion was noted in the right proximal femur. Incisional biopsy was performed on the large nodule shown in Figure to obtain a tissue diagnosis. During her NICU course, she also had frequent heme-positive stools but no feeding intolerance or clinical signs of bowel obstruction. She presented with rectal mucosal prolapse. A 5 mm polypoid lesion was noted in the rectum while the prolapse was treated by submucosal injection of 50% dextrose solution as a sclerosing agent. The patient presented one day later with what appeared to be recurrent rectal prolapse that was manually reduced. To further evaluate her gastrointestinal tract, a barium enema was performed, which revealed a colo-colonic intussusception localized to the sigmoid colon that was not reducible by hydrostatic technique, laparoscopic maneuver, or manual reduction. The patient underwent a sigmoid colectomy with primary anastomosis. A barium enema of the entire colon 3 months after resection did not identify any additional lesions. Her postoperative course was uneventful and she has been doing well for the past 6 months after the surgery.