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June 16, 1978

Pseudosarcomatous Fasciitis Revisited After 27 Years

Author Affiliations

Veterans Administration Hospital

Long Beach, Calif

JAMA. 1978;239(24):2552. doi:10.1001/jama.1978.03280510036014

To the Editor.—  Twenty-seven years ago the junior author (F.W.E.) noted a 1-cm, smoothly rounded, slightly tender mass, which had become noticeably enlarged to 2 cm, in the popliteal space of his left leg following a skiing trip, but it apparently was not related to this activity. The nodule was excised from the deep subcutaneous tissue. Microscopically it consisted of loosely arranged, plump, elongated, bizarre fibroblasts, some with mitotic figures, intermingled with lymphocytes, histiocytes, capillaries, and extravasated RBCs and embedded in a loose, edematous, and somewhat myxoid stroma. In some areas the lesion had the appearance of exuberant granulation tissue.Much concern was expressed because of the atypical microscopic features of the lesion and because the patient was a young physician, a few years out of medical school.The lesion was examined and reexamined extremely carefully by local pathologists, many of whom considered the lesion to be a low-grade malignant