Atypical location of nodular fasciitis in a pediatric patient: a case report and literature review

Maria Fernanda Figueroa Hernandez; Sabrina Escandón Perez; Clariza Cecilia Infante Fernandez; Cristina Berumen Glinz; Irene Montserrat Rodríguez Escamilla; Maria Elisa Vega Memije; Sonia Toussaint Caire

doi:10.18203/2349-3291.ijcp20261914

Authors

Maria Fernanda Figueroa Hernandez Department of Dermatology, General Hospital “Dr. Manuel Gea Gonzalez”, Ciudad de México, México
Sabrina Escandón Perez Department of Dermatology, General Hospital “Dr. Manuel Gea Gonzalez”, Ciudad de México, México
Clariza Cecilia Infante Fernandez Department of Pediatric Dermatology, General Hospital “Dr. Manuel Gea Gonzalez”, Ciudad de México, México
Cristina Berumen Glinz Department of Dermatology, General Hospital “Dr. Manuel Gea Gonzalez”, Ciudad de México, México
Irene Montserrat Rodríguez Escamilla Department of Dermatology, General Hospital “Dr. Manuel Gea Gonzalez”, Ciudad de México, México
Maria Elisa Vega Memije Department of Dermatology, General Hospital “Dr. Manuel Gea Gonzalez”, Ciudad de México, México
Sonia Toussaint Caire Department of Dermatology, General Hospital “Dr. Manuel Gea Gonzalez”, Ciudad de México, México

DOI:

https://doi.org/10.18203/2349-3291.ijcp20261914

Keywords:

Nodular fasciitis, Pseudosarcomatous fibromatosis, Myofibroblastic proliferation, Epidermoid cystic, Children

Abstract

Nodular fasciitis (NF) is a benign, rapidly growing soft tissue lesion that can mimic malignant neoplasms. First described in 1955, it is commonly seen in adults but remains rare in pediatric populations, particularly in the orbital region. A comprehensive literature review was conducted, analyzing all reported cases of orbital NF between 1990 and 2022. Key parameters included patient demographics, clinical presentation, histopathological findings, treatment approaches, and outcomes. Twenty cases were identified, with an equal distribution of male and female patients. The most common clinical presentation was a rapidly growing, painless orbital mass. Histopathological analysis revealed a spindle cell proliferation with myxoid stroma, positive immunostaining for actin and vimentin, and variable expression of other markers. Surgical excision was the primary treatment, with no reported recurrences or postoperative complications. Although rare, orbital NF should be considered in the differential diagnosis of pediatric soft tissue tumors. Awareness of its benign nature is crucial to avoid unnecessary aggressive treatments. Surgical excision remains the treatment of choice, although spontaneous regression has been reported. Further studies are needed to elucidate its etiology and optimize management strategies.

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