Pedal occurrence of nodular fasciitis: a case report

Nodular fasciitis occurs primarily in the soft tissue structures of the upper extremities and, more rarely, in the lower extremities. This mass, although benign, can mimic certain sarcomas and is therefore important to differentiate from more serious conditions. We report a case of nodular fasciitis of the foot in a healthy 47-year-old male who presented with increasing pain and swelling in his right third digit of 3 months duration. Initial radiographs revealed an irregular contour to the proximal phalanx with increased soft tissue density. Magnetic resonance imaging and computed tomography scans were obtained that revealed a soft tissue mass with bone erosion and fracture. Histologic analysis from a specimen obtained after excision of the lesion confirmed the diagnosis of hyalinizing nodular fasciitis. Nodular fasciitis in the foot can appear malignant from the clinical and histopathologic findings but can be differentiated. A quick and accurate diagnosis of this benign process can prevent a treatment program unnecessarily dangerous to the patient.