SUMMARYNodular fasciitis (NF) is an uncommon fibroblastic proliferation that usually arises in the extremities or trunk, less frequently in the head and neck region. It is frequently mistaken for a malignant tumour owing to its rapid growth, but it is ultimately a benign condition with spontaneous regression. We describe a case of a 17-month-old African girl with cervical NF in which spontaneous and complete regression of the lesion occurred following the diagnosis by fine needle aspiration cytology. We emphasise the importance of making an accurate and timely diagnosis, and the imperative role of fine needle aspiration cytology in this process, potentially avoiding further unnecessary surgical procedures. BACKGROUND

SummaryCushing syndrome (CS) in children is a rare disorder that is most frequently caused by an adrenal tumour or a pituitary corticotrophinsecreting adenoma. The management is challenging and requires an individualised approach and multidisciplinary care. We present the case of a 23-month-old female child with a history of excessive weight gain, growth failure, hirsutism, acne and behavioural difficulties. Investigations revealed elevated serum midnight cortisol and 24 h urinary free cortisol. Overnight dexamethasone suppression testing showed no suppression of cortisol levels. Abdominal imaging revealed a right-sided suprarenal mass. She underwent right adrenalectomy and the histology showed an adrenal cortical carcinoma. There was clinical improvement with catch-up growth and weight normalisation. Despite being rare in clinical practice, in a child with weight gain, hirsuitism and growth failure the diagnosis must be considered. The overall prognosis of CS in childhood is good, but challenges remain to ensure normal growth and body composition. BACKGROUND

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