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Nodular Fasciitis of the Neck Causing Emergency: A Case Report.
Serkan Yaşar Çelik1, Yelda Dere1, Özgür İlhan Çelik1
1Department of Pathology, Faculty of Medicine, Mugla Sıtkı Kocman University, Muğla, Turkey.
Oman Medical Journal
|January 3, 2017
Summary
Nodular fasciitis, a benign tumor, can be misdiagnosed due to rapid growth and cellular atypia. Correct diagnosis is crucial to prevent unnecessary treatments for this reactive lesion.
Area of Science:
- Pathology
- Oncology
- Surgical Oncology
Background:
- Nodular fasciitis is a benign, reactive lesion of fibroblasts and myofibroblasts, commonly found in extremities and trunk.
- Head and neck involvement occurs in 13-20% of cases, often presenting as a rapidly growing mass.
- Histological features like cellularity, atypia, and mitosis can lead to misdiagnosis as malignancy.
Observation:
- A case of an 82-year-old woman with a rapidly growing neck mass invasive to the trachea, causing progressive shortness of breath.
- The mass's location and rapid growth mimicked aggressive or malignant tumors.
- Surgical resection was not feasible due to the patient's general condition.
Findings:
- The neck mass, diagnosed as nodular fasciitis, caused significant airway obstruction.
- Local radiotherapy was administered, but it did not result in mass regression.
- The patient required symptomatic medical support for airway obstruction.
Implications:
- Accurate diagnosis of nodular fasciitis is essential to avoid overtreatment and unnecessary surgeries.
- This case highlights the challenges in diagnosing and managing nodular fasciitis, particularly in the head and neck region.
- Effective treatment strategies for unresectable or non-responsive nodular fasciitis require further investigation.