2019•International Journal of Surgery Case ReportsOpen access

Nodular fasciitis of the face: A case report

Shems Al-Hayder, Mads Warnecke, Jørgen Hesselfeldt-Nielsen

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Abstract

INTRODUCTION: Nodular fasciitis is a benign, self-limited myofibroblastic proliferative lesion of unclear aetiology. It is often misdiagnosed as a malignant tumour due to its rapid growth, high cellularity, and increased mitotic activity. PRESENTATION OF CASE: We present a case of nodular fasciitis occurring in the medial canthus of a 64-year-old, otherwise healthy, woman. The patient complained of rapidly enlarging asymptomatic subcutaneous nodule over a period of 6 months. The tumour was firm, smooth, and indolent with limited mobility. Fine-needle aspiration was inconclusive, and the CT scan showed a well-defined nodular lesion in the soft tissue without bone destruction. A local excision was performed, and the histopathological findings were consistent with nodular fasciitis. DISCUSSION: Although rare, nodular fasciitis is the most common pseudosarcoma of soft tissues. Local excision is recommended; however, the tumour often regresses spontaneously, and recurrence is exceedingly rare. CONCLUSION: Awareness of nodular fasciitis and its benign nature is essential to avoid misdiagnosis and subsequent inappropriate aggressive treatment of the patient.

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INTRODUCTION: Nodular fasciitis is a benign, self-limited myofibroblastic proliferative lesion of unclear aetiology. It is often misdiagnosed as a malignant tumour due to its rapid growth, high cellularity, and increased mitotic activity. PRESENTATION OF CASE: We present a case of nodular fasciitis occurring in the medial canthus of a 64-year-old, otherwise healthy, woman. The patient complained of rapidly enlarging asymptomatic subcutaneous nodule over a period of 6 months. The tumour was firm, smooth, and indolent with limited mobility. Fine-needle aspiration was inconclusive, and the CT scan showed a well-defined nodular lesion in the soft tissue without bone destruction. A local excision was performed, and the histopathological findings were consistent with nodular fasciitis. DISCUSSION: Although rare, nodular fasciitis is the most common pseudosarcoma of soft tissues. Local excision is recommended; however, the tumour often regresses spontaneously, and recurrence is exceedingly rare. CONCLUSION: Awareness of nodular fasciitis and its benign nature is essential to avoid misdiagnosis and subsequent inappropriate aggressive treatment of the patient.

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Available abstract

INTRODUCTION: Nodular fasciitis is a benign, self-limited myofibroblastic proliferative lesion of unclear aetiology. It is often misdiagnosed as a malignant tumour due to its rapid growth, high cellularity, and increased mitotic activity. PRESENTATION OF CASE: We present a case of nodular fasciitis occurring in the medial canthus of a 64-year-old, otherwise healthy, woman. The patient complained of rapidly enlarging asymptomatic subcutaneous nodule over a period of 6 months. The tumour was firm, smooth, and indolent with limited mobility. Fine-needle aspiration was inconclusive, and the CT scan showed a well-defined nodular lesion in the soft tissue without bone destruction. A local excision was performed, and the histopathological findings were consistent with nodular fasciitis. DISCUSSION: Although rare, nodular fasciitis is the most common pseudosarcoma of soft tissues. Local excision is recommended; however, the tumour often regresses spontaneously, and recurrence is exceedingly rare. CONCLUSION: Awareness of nodular fasciitis and its benign nature is essential to avoid misdiagnosis and subsequent inappropriate aggressive treatment of the patient.

Key concepts: Nodular fasciitis, Medicine, Soft tissue, Nodule (geology), Lesion, Wide local excision, Asymptomatic, Surgical excision

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