title: Nodular fasciitis in the head and neck: CT and MR imaging findings.
abstract: OBJECTIVE
  The purpose of this study was to describe the CT and MR imaging findings of nodular fasciitis occurring in the head and neck region.
  
  
  METHODS
  CT (n = 6) and MR (n = 4) images obtained from 7 patients (3 men and 4 women; mean age, 19.4 years; age range, 1-48 years) with surgically confirmed nodular fasciitis in the head and neck were retrospectively reviewed. All patients presented with a palpable mass in the head and neck that was noticed 1-3 months earlier: 5 in the face, one in the occipital scalp, and the remaining one in the supraclavicular fossa. We investigated the CT and MR imaging characteristics with emphasis on the location, size, internal content, margin, enhancement pattern, and signal intensity of the lesion.
  
  
  RESULTS
  All lesions appeared as a discrete mass on imaging, ranging from 1.0 cm to 4.6 cm in diameter (mean, 2.2 cm). Six lesions, all of which appeared benign, were located in the subcutaneous tissue superficial to the deep cervical fascia. The remaining lesion was located deep to the temporalis muscle and showed an aggressive imaging appearance, markedly eroding the bony orbit and skull. Five lesions were solid, and 2 lesions were partly or completely cystic in appearance. Five lesions were well defined, whereas 2 lesions were ill defined. Four of 5 solid lesions showed moderate to marked diffuse enhancement, whereas the remaining lesion demonstrated mild enhancement. Two cystic lesions showed peripheral, nodular, or rim-like enhancement. Compared with muscle, both solid lesions had isointense signal intensity on T1-weighted images and hyperintense signal intensity on T2-weighted images, whereas the signal intensity of the solid portions of the deep-seated, partly cystic lesion was isointense on both T1-weighted and T2-weighted images.
  
  
  CONCLUSIONS
  Although rare, nodular fasciitis occurs as a discrete solid or cystic mass in the head and neck, depending on the predominant stromal components. When one sees a head and neck mass with a superficial location and moderate to marked enhancement on CT and MR imaging, nodular fasciitis should be included in the differential diagnosis, especially in patients with a recently developed, rapidly growing mass and a history of recent trauma.
authors.affiliation: Department of Radiology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Kangnam-Ku, Seoul, Korea.
authors.forename: Sung Tae
authors.initials: ST
authors.lastname: Kim
authors.forename: Hyung-Jin
authors.initials: HJ
authors.lastname: Kim
authors.forename: Sun-Won
authors.initials: SW
authors.lastname: Park
authors.forename: Chung Hwan
authors.initials: CH
authors.lastname: Baek
authors.forename: Jung Hwan
authors.initials: JH
authors.lastname: Baek
authors.forename: Hong Sik
authors.initials: HS
authors.lastname: Byun
authors.forename: Young Mo
authors.initials: YM
authors.lastname: Kim
mesh_terms: D000293:Adolescent; D000328:Adult; D002648:Child; D005205:Fascia; D005208:Fasciitis / Q000145:classification / Q000000981:diagnostic imaging / Q000473:pathology*; D005260:Female; D006257:Head; D006801:Humans; D007223:Infant; D008198:Lymph Nodes / Q000000981:diagnostic imaging / Q000473:pathology*; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D009333:Neck; D012189:Retrospective Studies; D012720:Severity of Illness Index; D014057:Tomography, X-Ray Computed