Intradermal proliferative fasciitis in childhood: a potential diagnostic pitfall
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Gaetano Magro1, Michal Michal, Rita Alaggio
1Dipartimento G.F. Ingrassia, Policlinico Universitario G. Rodolico, Anatomia Patologica, Università di Catania, Catania, Italy. g.magro@unict.it
Insights
Proliferative fasciitis (PF), a rare condition, can occur in children’s dermis, not just fascia. This case highlights atypical mitoses, crucial for avoiding misdiagnosis of malignancy.
Area of Science:
- Dermatopathology
- Pediatric Pathology
- Oncology
Background:
- Proliferative fasciitis (PF) is a benign, pseudosarcomatous condition typically affecting subcutaneous tissue and fascia in adults.
- While PF can occur in children, it is uncommon, and usually presents in deeper tissues.
- Histological hallmarks include proliferation of ganglion-like and spindle cells, typically without atypical mitoses.
Observation:
- This report details a rare case of proliferative fasciitis (PF) occurring primarily within the dermis of a 13-year-old boy.
- This represents the first documented instance of PF originating in the dermal layer.
- The histological examination revealed rare atypical mitoses, a feature not commonly emphasized in previous descriptions of PF.
Findings:
- The study identifies proliferative fasciitis (PF) as a potential diagnosis for dermal lesions in pediatric patients.
- The presence of rare atypical mitoses in this pediatric dermal PF case is a significant, previously under-recognized finding.
- This case expands the known histological spectrum of PF, particularly in pediatric presentations.
Implications:
- Increased awareness of dermal PF in children is essential for accurate diagnosis.
- Recognizing atypical mitoses in pediatric dermal PF is critical to prevent misdiagnosis as a malignant neoplasm.
- This finding underscores the importance of considering benign pseudosarcomatous lesions in the differential diagnosis of pediatric skin tumors.
Abstract:
Proliferative fasciitis (PF) is a pseudosarcomatous proliferation which typically occurs in the subcutaneous tissue and fascia. Although patients are characteristically middle-aged people, occasionally PF can arise in children. Histologically, PF is characterized by a proliferation of large ganglion-like and spindle-shaped cells which, especially in childhood, may exhibit high mitotic activity, but no atypical mitoses. We report a case of PF in the dermis of a 13-year-old boy. This is the first case of PF primarily arising in the dermis. Apart from the unusual site, another intriguing finding was the presence of rare atypical mitoses, a feature which has not been previously emphasized in PF. Awareness that PF may occur in the dermis, exhibiting occasional atypical mitoses, is crucial to avoid a misdiagnosis of malignancy.
