Nodular fasciitis of the neck causing emergency: A case report

Abstract

Nodular fasciitis is a benign, reactive, tumor-like lesion composed of fibroblasts and myofibroblasts. It typically occurs in the extremities and the trunk. Head and neck localization is 13-20%. As it grows rapidly, clinicians frequently misdiagnose it as an aggressive or a malignant lesion. Some lesions show moderate cellularity, mild cellular atypia, and mitosis histologically causing pathologists to over-diagnose the lesion as a malignant tumor. It is important to diagnose nodular fasciitis correctly to avoid unnecessary additional surgery and treatment. We report the case of an 82-year-old woman who was admitted to the emergency department with a one-month history of progressive shortness of breath. We found a mass in the patient’s neck, invasive to the trachea, which was the cause of her symptom. Complete radical surgery of the mass with the larynx was impossible due to her general status. The mass was treated by local radiotherapy; however, no regression was seen in the size of the mass. The patient is still on follow-up with only symptomatic medical support for airway obstruction. © 2017, Oman Medical Specialty Board. All rights reserved.