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Nodular fasciitis: a case series

Published online by Cambridge University Press:  13 June 2008

S D Reitzen ,
S Dogan  and
G Har-El
S D Reitzen*
Affiliation:
Department of Otolaryngology, New York University Medical Center, New York, New York, USA
S Dogan
Affiliation:
Department of Pathology, Lenox Hill Hospital, New York, New York, USA
G Har-El
Affiliation:
Department of Otolaryngology, Lenox Hill Hospital, New York, New York, USA
*
Address for correspondence: Dr Shari D Reitzen, New York University Medical Center, Department of Otolaryngology, 550 First Avenue, NBV 5E5, New York, NY 10016, USA. Fax:  +1 212 434 4222 E-mail: reitzs01@med.nyu.edu
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Abstract

Background:

Given its rarity, varied histological presentation and often pseudosarcomatous appearance, nodular fasciitis is frequently misdiagnosed on pre-operative, intra-operative and final analyses.

Methods:

Four cases of nodular fasciitis are reviewed.

Results:

Physical and radiological findings were consistent with a parapharyngeal tumour, probably neurogenic, a level four neck mass suspicious for lymphoma; a sternoclavicular mass in a patient with a history of breast cancer suspicious for metastasis; and a cheek mass consistent with an accessory parotid tumour. Fine needle aspiration results were consistent with a neurogenic tumour in two patients and an undifferentiated malignancy in two patients. Frozen section examination most commonly included masses with spindle-type cells. The final diagnosis of nodular fasciitis was made only after permanent section and immunohistological analysis.

Conclusions:

In a patient with nonspecific results following investigation of a head or neck mass, nodular fasciitis should be considered. Use of appropriate immunohistochemical markers will aid in the final diagnosis.

Keywords

Nodular FasciitisHead And Neck NeoplasmsSarcoma
Type
Main Articles
Information
The Journal of Laryngology & Otology , Volume 123 , Issue 5 , May 2009 , pp. 541 - 544
Copyright
Copyright © JLO (1984) Limited 2008

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Footnotes

Presented as a poster at the Head and Neck Society Meeting, Combined Otolaryngologic Spring Meetings, 28 April 2007, San Diego, California, USA.

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