Nodular fasciitis: a sarcomatous impersonator

Tomita, Sandra; Thompson, Kenneth; Carver, Thomas; Vazquez, W. David

doi:10.1016/j.jpedsurg.2009.01.047

Cited by 34 publications

(28 citation statements)

References 8 publications

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“…Although a predilection in males has been suggested, our case series showed no sex predilection, with an approximately equal number of boys and girls. Tomita et al 6 presented 25 cases of nodular fasciitis over a 10-year period. Of the 3 patients younger than 18 years in the series, 1 had a lesion located in the forehead and those of the others were in the chest wall and left flank.…”

Section: Discussionmentioning

confidence: 99%

Pediatric Nodular Fasciitis in the Head and Neck

Hseu

Watters

Perez‐Atayde

et al. 2015

JAMA Otolaryngol Head Neck Surg

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Section: Discussionmentioning

confidence: 99%

Pediatric Nodular Fasciitis in the Head and Neck

Hseu

Watters

Perez‐Atayde

et al. 2015

JAMA Otolaryngol Head Neck Surg

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“…NF in more usual locations is frequently incorrectly considered a malignant lesion due to its rapid growth, presence of a high cellularity, abundant mitotic figures, and capacity to be poorly circumscribed, and NF of the parotid gland is Other malignancies (dermatofibrosarcoma protuberans, myxofibrosarcoma, rhabdomyosarcoma, angiosarcoma) are rarely included in the histologic or cytologic differential diagnosis [11,16,18,22,23,27,28,30]. Needless to say, this is a broad reactive and neoplastic differential Fig.…”

Section: Differential Diagnosismentioning

confidence: 99%

Parotid Gland Nodular Fasciitis: A Clinicopathologic Series of 12 Cases with a Review of 18 Cases from the Literature

Gibson

Bishop

Thompson

2014

Head and Neck Pathol

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Nodular fasciitis (NF), very uncommon in the parotid gland, is a benign myofibroblastic proliferation that may be mistaken for other neoplastic proliferations. The mass-like clinical presentation and histologic features result in frequent misclassification, resulting in inappropriate clinical management. There are only a few reported cases in the English literature. Cases within the files of the authors' institutions (retrospective) confined to the parotid gland were compared to cases reported in the English literature (Medline 1966-2014). The patients included five females and seven males, aged 11-70 years (mean 45.2 years). All patients presented with a mass lesion, present on average 1.9 months, without a documented history of trauma. The lesions were 0.7-5.2 cm (mean 2.2 cm). Seven patients had fine needle aspiration. The majority of the lesions were circumscribed (n = 9), composed of spindle-shaped to stellate myofibroblasts (MF) arranged in a storiform growth pattern, juxtaposed to hypocellular myxoid tissue-culture-like areas with extravasation of erythrocytes. Dense, keloid-like collagen (n = 7) and occasional giant cells were seen (n = 6). Mitotic figures (without atypical forms) were readily identifiable (mean 4/10 HPFs). By immunohistochemical staining, the MF were reactive with vimentin, actins, and calponin, while the histiocytes were reactive with CD68. All patients had surgical excision. One patient developed local recurrence (12 months later). All were alive and disease free at last follow-up, with a mean 133 months of follow-up. The principle differential diagnoses include fibrosarcoma, fibromatosis, pleomorphic adenoma, myoepithelioma, neurofibroma, schwannoma, solitary fibrous tumor, leiomyoma, fibrous histiocytoma and myxoma. NF of the parotid gland occurs in middle-aged patients who present with a mass (mean 2.2 cm) in the parotid gland of short duration (1.9 months). FNA misinterpretation frequently leads to excision. Separation from myoepithelial and mesenchymal lesions affecting the parotid gland results in appropriate management.

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“…[1][2][3] This deceptive histological appearance may result in erroneous diagnoses and inadequate treatment. [4][5][6] Since its initial description by Konwaler et al, 7 the neoplastic nature of NF has been debated. [8][9][10][11] Although a few studies showed evidence that at least a subset of NF were clonal in nature, others were unable to confirm these findings.…”

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confidence: 99%

Nodular fasciitis: a novel model of transient neoplasia induced by MYH9-USP6 gene fusion

Erickson-Johnson

Chou

Evers

et al. 2011

Laboratory Investigation

337

246

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Nodular fasciitis (NF) is a relatively common mass-forming and self-limited subcutaneous pseudosarcomatous myofibroblastic proliferation of unknown pathogenesis. Due to its rapid growth and high mitotic activity, NF is often misdiagnosed as a sarcoma. While studying the USP6 biology in aneurysmal bone cyst and other mesenchymal tumors, we identified high expression levels of USP6 mRNA in two examples of NF. This finding led us to further examine the mechanisms underlying USP6 overexpression in these lesions. Upon subsequent investigation, genomic rearrangements of the USP6 locus were found in 92% (44 of 48) of NF. Rapid amplification of 5 0 -cDNA ends identified MYH9 as the translocation partner. RT-PCR and direct sequencing revealed the fusion of the MYH9 promoter region to the entire coding region of USP6. Control tumors and tissues were negative for this fusion. Xenografts of cells overexpressing USP6 in nude mice exhibited clinical and histological features similar to human NF. The identification of a sensitive and specific abnormality in NF holds the potential to be used diagnostically. Considering the self-limited nature of the lesion, NF may represent a model of 'transient neoplasia', as it is, to our knowledge, the first example of a self-limited human disease characterized by a recurrent somatic gene fusion event.

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Nodular fasciitis: a sarcomatous impersonator

Cited by 34 publications

References 8 publications

Pediatric Nodular Fasciitis in the Head and Neck

Pediatric Nodular Fasciitis in the Head and Neck

Parotid Gland Nodular Fasciitis: A Clinicopathologic Series of 12 Cases with a Review of 18 Cases from the Literature

Nodular fasciitis: a novel model of transient neoplasia induced by MYH9-USP6 gene fusion

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