Nodular Fasciitis of the Periorbital Area

Abstract

Nodular fasciitis is a reactive, non-neoplastic lesion that is most commonly found in the subcutaneous or superficial fascia of the extremities and trunk. Head and neck lesions are relatively uncommon and reports vary from 7% to 15% depending on the authors. Nodular fasciitis grows quickly, and shows a pleomorphic spindle cell pattern with increased mitotic activity. Such factors lead to cases where the lesion is mistaken for a malignancy such as fibrosarcoma and the case may end up with unnecessarily aggressive treatments. The intent of this paper is to report a relatively rare case of nodular fasciitis occurring in the periorbital area and also to highlight the importance of accurate diagnosis and non-aggressive management of this benign lesion.

A rapidly enlarging left medial orbital lesion

“…8 Recurrent masses are so uncommon that malignancies should be considered with careful reassessment of the original diagnosis. 9 Our patient has been followed up for 1 year with no recurrence of the lesion. He has no epiphora and the incision has healed well.…”

Nodular fasciitis with prominent myxoid changes on the face

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Nodular fasciitis (NF) usually occurs on the trunk and upper extremities, but can also involve the periorbital and orbital regions of the face. 1,2 We report a rare case of NF with extraordinarily prominent myxomatous components on the face.A 30-year-old Japanese woman was referred to our hospital with a subcutaneous nodule on the right cheek that had enlarged for 3 months. The nodule was tender, slightly elevated, covered with normal-colored skin, and freely movable from the underlying tissue (Figure 1a).

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“…Nodular fasciitis (NF) usually occurs on the trunk and upper extremities, but can also involve the periorbital and orbital regions of the face. 1,2 We report a rare case of NF with extraordinarily prominent myxomatous components on the face.…”