Giant Intramuscular Nodular Fasciitis Masquerading as Soft Tissue Sarcoma with Neural Involvement - A Case Report

Nodular Fasciitis (NF) is described as a benign reactive proliferation of myofibroblasts that occurs predominantly in the subcutaneous location. Most commonly presents as rapidly growing swelling in the young adults, with usual size of less than 4cm and located commonly in the extremities. We hereby report a case of giant nodular fasciitis of 10cm diameter which presented in an unusual location (gluteal region) and rare plane of origin (intramuscular) with unusual symptom of sciatic nerve involvement. Because of the size, location and neural involvement a clinical diagnosis of soft tissue sarcoma was made. After investigating with trucut biopsy and magnetic resonance imaging, benign nature of the lesion confirmed and treated with complete excision, carefully preserving the sciatic nerve. This case is presented for its rarity in size, location, plane of origin and neural compression. To the best of our knowledge this is the first case of nodular fasciitis of 10cm size and in the gluteal muscles.