Nodular Fasciitis

Introduction

A common reactive lesion that usually occurs in upper extremities of young people (ages 15-35) Incidence most common fibrous soft tissue lesion half of the cases occur in the upper extremities Demographics males and females equally affected Body locations volar forearm, back, chest wall, head and neck

Presentation

Symptoms may be painless or painful painful in half of patients often rapidly enlarging mass over 1 to 2 weeks lesions 1 to 2 cm

Imaging

Radiograph   usually normal MRI  shows deep seated inhomogeneous mass  nodularity with extension along the fascial planes avid enhancement with gadolinium most commonly is superficial but can occur intramuscularly or along the superficial plane

Histology

Classic characteristics are short irregular bundles and fascicles  dense reticulum network small amounts of mature collagen

Treatment

Operative marginal resection

Differentials & Groups

Treated with marginal excision (2)   Nodular fasciitis (soft tissue)         •   Periosteal chondroma         •   Neurilemoma (soft tissue)         •   Epidermal inclusion cyst         •   Glomus tumor         •

Ibank

Location Xray Xray CT B. Scan MRI MRI Histo(1) Case A tibia             (1) - histology does not always correspond to case

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