Nodular fasciitis affecting the masseter – A rare and rapidly growing mass

Tocaciu, Shreya; Phung, Teik Beng; Sim, Felix

doi:10.1016/j.ajoms.2019.01.004

Cited by 1 publication

(5 citation statements)

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“…Furthermore, sarcoma will exhibit cellular pleomorphism and atypia, which should not be seen in NF [3]. Important clinical and histological differential diagnoses of NF include sarcoma [4], fibrosarcoma, fibrous histiocytoma, or myofibromatosis [5].…”

Section: Discussionmentioning

confidence: 99%

“…As compared to sarcoma, NF tend to be smaller on diagnosis (less than 40 mm), sharply demarcated (although an infiltrative edge can be seen), with myxoid stroma, and have scant lymphocytic infiltrate with erythrocytes [ 2 ]. Furthermore, sarcoma will exhibit cellular pleomorphism and atypia, which should not be seen in NF [ 3 ]. Important clinical and histological differential diagnoses of NF include sarcoma [ 4 ], fibrosarcoma, fibrous histiocytoma, or myofibromatosis [ 5 ].…”

Section: Discussionmentioning

confidence: 99%

“…Important clinical and histological differential diagnoses of NF include sarcoma [ 4 ], fibrosarcoma, fibrous histiocytoma, or myofibromatosis [ 5 ]. A relationship between NF and mechanical stimulus has been suggested [ 1 ], so NF patients may also describe a history of trauma, although this is not always identified [ 3 ]. At first, because the tumor development originated from the surgical wound, port site recurrence was suspected based on a history of rectal cancer.…”

Section: Discussionmentioning

confidence: 99%

“…However, possibility for recurrence was supposed to be low considering the diagnosis of the stage of rectal cancer as stage I pT2N0M0. Ultrasound-guided FNA may inform a diagnosis, although FNA results have been inconclusive in many reported cases [ 3 ], including ours. The issue of misdiagnoses of NF as other malignant pathologies has also been raised by some authors [ 6 ], particularly where NF was incorrectly diagnosed as desmoid-type fibromatosis, committing patients to a more aggressive surgical approach [ 7 ].…”

Section: Discussionmentioning

confidence: 99%

“…For example, leiomyosarcomas stain positive for desmin, whereas NF does not [ 8 ]. On confirmation of NF, an excisional biopsy is both diagnostic and therapeutic, with recurrence unlikely [ 3 ]. Any reported recurrence may indicate either an incomplete excision or the misdiagnosis of a malignant process [ 4 ].…”

Section: Discussionmentioning

confidence: 99%

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Nodular fasciitis growing at the port site of robotic surgery for rectal cancer

et al. 2020

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Background Nodular fasciitis (NF) is a type of rare and rapidly growing tumor that affects the muscular fascial layers. Due to its locally aggressive nature and rapid growth, NF can be mistaken as a malignant process on either clinical or histological grounds. Case presentation A 61-year-old man was affected by rectal cancer. We performed a robotic, high-anterior resection with lymph node dissection. According to the 8th edition of Union for International Cancer Control, the diagnosis was stage I pT2N0M0. During a routine follow-up 1.5 years after the robotic surgery, a computed tomography examination revealed a tumor in the upper right abdominal wall, at the site of the surgical port, that measured 45 mm. Magnetic resonance imaging indicated a hypo-intensive mass within the right straight muscle of the abdomen. Port site recurrence following the robotic surgery for rectal cancer was suspected, and an ultrasound-guided fine-needle aspiration was performed; it revealed a low-grade myofibroblastic tumor or benign neoplasm, but was inconclusive. We performed an excision of the lesion, and histopathology confirmed NF, seen as a solid, nodular, spindle-cell lesion. The patient was postoperatively followed for more than 1 year without any sign of recurrence of either cancer or NF. Conclusions NF is histologically benign, but local recurrence frequently occurs. We encountered a patient with NF at the port site after robotic surgery for rectal cancer.

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Section: Discussionmentioning

confidence: 99%