Nodular fasciitis: spontaneous resolution following diagnosis by fine-needle aspiration.
Nodular fasciitis can be histologically mistaken for a sarcoma. Typical cases are less than 5 cm and enlarge rapidly over days or weeks before diagnosis. The natural history of nodular fasciitis is unknown, since the diagnosis is usually based on excised lesions. Fine-needle aspiration of nodular fasciitis has been described, and features benign-appearing spindle cells (singly and in groups), collagen, and myxoid material. We describe 11 cases in which nonsurgical observation led spontaneously to complete resolution. Our study includes 7 males and 4 females (24 to 73 years of age; median = 42). Lesions were located in the arm (4), thigh (3), temporal area (2), breast (1) and the parotid (1) and ranged from 0.5 to 5.0 cm. (median = 1.5). They had been present for from less than 1 to 4 weeks (median = 2). In 9 cases, spontaneous resolution occurred in from 3 to 8 weeks (median = 4). Two other patients were lost to follow-up for up to 11 months, after which resolution was noted. Small palpable masses in the subcutaneous soft tissues which evolve over a short period of time and show the cytologic features of nodular fasciitis should be managed nonsurgically. If resolution does not occur within a few weeks, surgery can then be performed.
Department of Pathology, University of Arkansas for the Medical Sciences, Little Rock.
M W
MW
Stanley
L
L
Skoog
E M
EM
Tani
C A
CA
Horwitz
D000328:Adult; D000368:Aged; D001707:Biopsy, Needle; D002466:Cell Nucleolus / Q000473:pathology; D002467:Cell Nucleus / Q000473:pathology; D003581:Cytodiagnosis; D003593:Cytoplasm / Q000473:pathology; D005208:Fasciitis / Q000175:diagnosis* / Q000473:pathology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged