Nodular fasciitis-often a tumor mimic

Authors

  • Sriram Jaganathan Department of Radiodiagnosis, Global Hospitals and Healthcity, Chennai, Tamil Nadu, India

DOI:

https://doi.org/10.18203/2320-6012.ijrms20222644

Keywords:

Benign, Fibroblast, Myofibroblasts, Tender

Abstract

Nodular fasciitis is a benign proliferation of fibroblasts and myofibroblasts. It is frequently mistaken for a sarcomatous lesion because of its rapid growth, imaging features and aggressive pathological findings. Though imaging plays a vital role in evaluating these lesions, strong suspicion with a careful histopathology is the final answer. We present a patient with nodular fasciitis involving the upper extremity. A 15-year-old boy presented with complaints of progressively increasing right wrist swelling since 2 months, and had been having severe pain on exertion. On clinical examination the swelling was tender. MRI revealed T2 hyperintense lesion along the volar-lateral aspect of wrist, completely encasing the abductor pollicis longus tendon and indenting the extensor pollicis brevis tendon. Per operatively, the tumor was seen to involve the abductor pollicis longus tendon sheath and insinuating between the tendons. Excision biopsy was performed and histopathology confirmed the diagnosis of nodular fasciitis.

References

Konwaler BE, Keasbey L, Kaplan L. Subcutaneous pseudosarcomatous fibromatosis (fasciitis). Am J Clin Pathol. 1955;25:241-52.

Katz MA, Beredjiklian PK, Wirganowicz PZ. Nodular Fasciitis of the Hand: A Case Report. Clin Orthopaed Related Res. 2001;382:108-11.

Bernstein KE, Lattes R. Nodular (pseudosarcomatous) fasciitis, a nonrecurrent lesion: A clinicopathologic study of 134 cases. Cancer. 1982;49:1668-78.

Brimhall CL, Segura AD, McTigue MK, Easterly NB. Nodular fasciitis on the palm of a child. Arch Dermatol. 1989;125:1441-2.

Jong HS, Jeong SY, Chan BP. Nodular fasciitis in chest wall on a teenager: a case report and review of the literature. J Thoracic Disease. 2014;6;6.

Allen PW. Nodular fasciitis. Pathology. 1972;4:9-26.

Price EB Jr, Silliphant WM, Shuman R. Nodular fasciitis: a clinicopathologic analysis of 65 cases. Am J Clin Pathol. 1961;35:122-36.

Fletcher CDM, Bridge JA, Hogendoorn PCW. WHO Classification of tumours of soft tissue and bone. Pathology and genetics of tumours of soft tissue and bone. 4th ed. Lyon, France: IARC Press. 2013.

Shin C, Low I, Ng D, Oei P, Miles C, Symmans P. USP6 gene rearrangement in nodular fasciitis and histological mimics. Histopathology. 2016;69:784-91.

Al-Hayder S, Warnecke M, Hesselfeldt-Nielsen J. Nodular fasciitis of the face: A case report. Int J Surg Case Rep. 2019;61:207-9.

Wu SY, Zhao J, Chen HY, Hu MM, Zheng YY, Min JK et al MR imaging features and a redefinition of the classification system for nodular fasciitis. Medicine (Baltimore). 2020;99(45):e22906.

Leung LY, Shu SJ, Chan AC. Nodular fasciitis: MRI appearance and literature review. Skeletal Radiol 2002;31:9-13.

Coyle J, White LM, Dickson B. MRI characteristics of nodular fasciitis of the musculoskeletal system. Skeletal Radiol 2013;42:975-82.

Lu L, Lao IW, Liu X. Nodular fasciitis: a retrospective study of 272 cases from China with clinicopathologic and radiologic correlation. Ann Diagn Pathol. 2015;19:180-5.

Bemrich-Stolz CJ, Kelly DR, Muensterer OJ. Single institution series of nodular fasciitis in children. J Pediatr Hematol Oncol. 2010;32:354-7.

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Published

2022-10-28

How to Cite

Jaganathan, S. (2022). Nodular fasciitis-often a tumor mimic. International Journal of Research in Medical Sciences, 10(11), 2677–2679. https://doi.org/10.18203/2320-6012.ijrms20222644

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Section

Case Reports