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Nodular fasciitis: clinical characteristics and preoperative diagnosis
Ching-Chi Chi1, Tseng-Tong Kuo, Shu-Hui Wang
1Department of Dermatology, Chang Gung Memorial Hospital-Chiayi, Taiwan.
Background And Purpose:
Because of its rapid growth, hypercellularity, and brisk mitotic rate, nodular fasciitis (NF) is probably the most common benign mesenchymal tumor that is misdiagnosed as a sarcoma, often leading to unnecessary and overly aggressive therapy.
Methods:
This retrospective study evaluated the characteristics of 92 well-documented cases of NF treated from 1988 to 2001. Gender, age, location, size, and clinical symptoms were analyzed, as was the accuracy of preoperative diagnosis.
Results:
Females were predominant (male-to-female ratio, 1:1.71; p = 0.006, binomial distribution). Accurate preoperative diagnosis was made in only 14.1%, but this rate improved in recent years (p = 0.034, chi-squared test for trend). The pathologic subtype of NF did not correlate with the duration of the lesion.
Conclusions:
Clinicians should include NF in the differential diagnosis of rapidly growing subcutaneous tumors and not rush to overly aggressive therapy.