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Nodular fasciitis: a case series

Published online by Cambridge University Press:  13 June 2008

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

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.

Type
Main Articles
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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