Nodular fasciitis of the face: aesthetic considerations

Nodular fasciitis is an uncommon tumor-like fibroblastic proliferation that occurs rarely in the head and neck region. A new case of nodular fasciitis occurring in the cheek of a 56-year-old woman is reported. The case was characterized by dental trauma preceding the appearance of the lesion (extraction of tooth 35). Histologically, the lesion consisted of proliferating fibroblasts and myofibroblasts presenting clinically as a rapidly growing subcutaneous nodule. A conservative surgical excision with curettage is the treatment of choice, and the lesion usually does not exhibit a tendency to recur. The clinical relevance of this condition relies on the fact that both the disorder and its surgical treatment may cause tissue distortion resulting in aesthetic compromise. Furthermore, it needs to be differentiated from malignancy due to its very rapid growth, its rich cellularity, and its high mitotic activity. Both of these aspects, i.e. aesthetic implications and differential diagnosis, have been discussed.