Nodular Fasciitis of Temporal Fossa Involving the Facial Nerve: Postoperative Evaluation in the Telemedicine Era

Abstract

N odular fasciitis is a benign growth that results from fibroblast proliferation, often after trauma. 1 This typically arises from deep fascial layers and may mimic malignancy. In children, nodular fasciitis is most often reported in the head and neck. 2 Involvement of neurovascular structures such as the facial nerve has been described and in some cases has led to avoidance of surgical excision given risk of damage. 3 Here, we present the case of a young man with a 1-month history of an enlarging, painless temporal mass. His postoperative course was timed with a global pandemic but was amenable to telemedicine and demonstrated full return of nerve function.

Knob, Clot, Protuberance–Nodular Fasciitis

“…Additionally designated as cranial fasciitis, nodular fasciitis enunciates significant anatomic distribution of lesions. Terminology of pseudo-sarcomatous fasciitis remains obsolete [1,2].…”

“…Frequently encountered, the mesenchymal neoplasm is predominantly discerned in young adults although no age of tumour emergence is exempt. A specific gender predilection is absent [1,2].…”

“…Of obscure aetiology, nodular fasciitis may arise as a sporadic neoplasm [1,2]. Neoplastic cells preponderantly depict genomic fusion of MYH9-USP6 genes.…”

“…In addition, several genes may collaborate with USP6 gene. Genetic rearrangement of USP6 gene can be ascertained with molecular techniques as fluorescent in situ hybridization (FISH), polymerase chain reaction (PCR) or next generation sequencing (NGS) [1,2].…”

“…Tumefaction may be asymptomatic or manifests as a tender, mildly painful, miniature nodule generally < 3 centimetre magnitude. Enlarged or rapidly progressive lesions necessitate demarcation from various malignant neoplasms [1,2]. Upon gross examination, a solitary, soft to firm, greyish/ white, tan or light pink tumefaction is discerned.…”