Nodular fasciitis in the head and neck. A clinicopathological study of 18 cases

Nodular fasciitis, a benign, pseudosarcomatous proliferative lesion of the soft tissue, is frequently misinterpreted as sarcoma, both clinically and microscopically. A series of 18 cases of nodular fasciitis in the head and neck region is presented. The clinical observations and the light microscopy are described. Ten out of the 18 cases were situated deep in the soft tissue; six were located close to the mandible and another 6 along the sternocleido mastoid muscle, seeming to support the view that nodular fasciitis may be ascribed to a reparative response to local mechanical events caused by injury. The diagnosis and differential diagnosis in relation to other benign and malignant tumours occurring in the region are discussed. The importance of otolaryngologists being aware of the existence of this entity in this area of the body is stressed. Follow-up information for 12 of the patients confirmed a perfectly benign clinical course, and simple excision, as tissue-sparing as possible, is therefore the treatment of choice.