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Nodular fasciitis: A rapidly enlarging destructive periorbital mass in an infant

R Tom Liu1, Erika Henkelman2, Oana Popescu3

  • 1Department of Ophthalmology and Visual Sciences, The University of British Columbia, Vancouver, Canada.

American Journal of Ophthalmology Case Reports
|January 9, 2019
PubMed

Insights

Nodular fasciitis is a rare benign tumor that can mimic orbital malignancy in infants. Prompt investigation and surgical repair of associated orbital wall erosion can lead to favorable outcomes.

Area of Science:

  • Ophthalmology
  • Pediatric Oncology
  • Pathology

Background:

  • Nodular fasciitis is a rare benign soft tissue tumor.
  • It can present as a rapidly growing periorbital mass, mimicking orbital malignancy.
  • Early diagnosis is crucial, especially in pediatric cases.

Observation:

  • A 9-month-old boy presented with a rapidly growing periorbital mass.
  • Computerized tomography (CT) scans revealed significant erosion of the lateral orbital wall.
  • Incisional biopsy confirmed nodular fasciitis, with negative USP6 gene rearrangement.

Findings:

  • Nodular fasciitis can cause extensive bony erosion in the orbit.
  • Complete surgical excision is feasible for this benign tumor.
  • Repair of orbital wall defects using polydioxanone (PDS) plates can restore function and aesthetics.

Implications:

  • Nodular fasciitis requires prompt investigation due to its malignant-like presentation.
  • Orbital wall erosion, though rare, can be successfully managed in pediatric patients.
  • Multidisciplinary management ensures good functional and cosmetic results for orbital tumors.
Abstract

Keywords:
Nodular fasciitisPeriorbital massReconstruction

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