Nodular fasciitis in the parotid region of a child

Nodular fasciitis is a common pathologic entity in the limbs of adults but rare in the head and neck of children. It is defined by the World Health Organization as a benign and probably reactive fibroblastic growth extending as a solitary nodule from superficial fascia into subcutaneous tissue. Treatment is local excision, and recurrence is rare.

Case Report

A 3.5-year-old boy was initially seen with a 1-year history of gradually enlarging but otherwise asymptomatic right facial mass. On examination, a firm nodule was palpable anterior to the right ear, and facial movement was symmetrical. Computed tomography showed a rounded, well-defined solid mass continuous with the parotid fascia. The patient underwent superficial parotidectomy without complication. The pathology was reported as nodular fasciitis, and the child has had no clinical recurrence over 2 years.

Benign lesions in this region in children may present similarly to malignancies but require much more-conservative treatment.