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Clinical Problem Solving: Radiology
December 15, 2008

Radiology Quiz Case: Diagnosis

Author Affiliations
 

A. HUDGINSPATRICIAMD

Arch Otolaryngol Head Neck Surg. 2008;134(12):1340-1341. doi:10.1001/archotol.134.12.1340

Nodular fasciitis, also known as subcutaneous pseudosarcomatous fasciitis or proliferative fasciitis, is a rare benign soft-tissue proliferation of fibroblasts. Despite being rare, it is the most common soft-tissue pseudosarcoma. It is most commonly found in the upper extremities, followed by the head and neck (which includes about 15%-20% of reported cases), the lower extremities, and finally the trunk.1This lesion occurs equally among men and women and is most commonly found in young adults between 20 and 40 years of age.2It is occasionally difficult to diagnose and can often be confused with a sarcoma owing to its rapid rate of growth, high cellularity, mitotic activity, and infiltrative borders.3A previous theory of pathogenesis suggested that NF is an atypical form of granulation tissue that is reactive and brought about by minor trauma; however, the majority of cases have not involved a history of trauma.1Rare links have also been suggested between NF and hyperestrogenic states such as pregnancy; however, the true pathogenesis remains unknown.4

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