Nodular Fasciitis With Degeneration and Regression

Abstract

Nodular fasciitis is a benign reactive proliferation that is frequently misdiagnosed as a sarcoma. This article describes a case of nodular fasciitis of 6-month duration located in the cheek, which degenerated and spontaneously regressed after biopsy. The nodule was fixed to the zygoma but was free from the overlying skin. The mass was 3.0 cm in diameter and demonstrated high signal intensity on T2-weighted magnetic resonance imaging. A small part of the lesion was biopsied. Pathological and immunohistochemical examinations identified the nodule as nodular fasciitis with myxoid histology. One month after the biopsy, the mass showed decreased signal intensity on T2-weighted images and measured 2.2 cm in size. The signal on T2-weighted images showed time-dependent decreases, and the mass continued to reduce in size throughout the follow-up period. The lesion presented as hypointense to the surrounding muscles on T2-weighted images and was 0.4 cm in size at 2 years of follow-up. This case demonstrates that nodular fasciitis with myxoid histology can change to that with fibrous appearance gradually with time, thus bringing about spontaneous regression. Degeneration may be involved in the spontaneous regression of nodular fasciitis with myxoid appearance. The mechanism of regression, unclarified at present, should be further studied.

Oral nodular fasciitis: Report of a case of the buccal mucosa

“…However, the lesion is often self-limiting. Yanagisawa and Okada (2008) report a case of nodular fasciitis of the cheek that degenerated and spontaneously regressed after biopsy. The authors conclude that "nodular fasciitis with myxoid histology can change to that with fibrous appearance gradually with time, thus bringing about spontaneous regression".…”

Fascitis nodular en la región frontal: a propósito de un caso excepcional y revisión de la literatura

“…Solo hay 4 casos descritos de regresión espontánea, uno por degeneración y los otros 3 tras la realización de una ECO-PAAF, pero dada la rareza del diagnóstico y su alto potencial de confusión con sarcoma maligno, la exéresis quirúrgica y su estudio histopatológico son necesarios para su adecuado diagnóstico 14 . Se ha descrito en la literatura un caso de recidiva de FN, cuyo tratamiento consistió en la inyección intralesional de corticoides como alternativa a la cirugía, pero este tratamiento presenta controversias y requiere un mayor estudio para obtener datos concluyentes 15 .…”

Nodular Fasciitis

“…The aggressive clinical presentation and imaging appearance of nodular fasciitis will usually prompt a biopsy for definitive diagnosis. Several case reports have described spontaneous regression or a decreased size of the lesion after percutaneous biopsy 3 , 15 . However, because of their rapid growth, these lesions are usually managed surgically and resected.…”