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Buac NP, Lee L, Vijayakumar G, Gusho C, Blank AT. Intra-Articular Nodular Fasciitis of the Knee, A Rare Clinical Presentation and Histological Diagnosis: A Case Report. Orthop Rev (Pavia) 2024; 16:94572. [PMID: 38505139 PMCID: PMC10950201 DOI: 10.52965/001c.94572] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/06/2022] [Accepted: 02/05/2024] [Indexed: 03/21/2024] Open
Abstract
Introduction Nodular fasciitis is a rare, benign soft tissue lesion that can prove to be difficult to diagnose, especially when intra-articular. Case presentation A 17-year-old female softball player presents with several year history of right knee pain and swelling initially attributed to patellar maltracking refractory to non-operative and operative management. Management and Outcomes Initial pathology suggested tenosynovial giant cell tumor; however, further tissue diagnosis revealed nodular fasciitis, which was eventually resected. Conclusion Intra-articular nodular fasciitis of the knee is rare and may easily be misdiagnosed due to its nonspecific clinical presentation. Careful histological examination can aid in diagnosis. Nodular fasciitis should be considered in the differential diagnoses for intra-articular lesions of the knee joint.
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Lin W, Bao L. Nodular fasciitis of the breast: the report of three cases. BMC Womens Health 2022; 22:54. [PMID: 35241055 PMCID: PMC8896292 DOI: 10.1186/s12905-022-01631-2] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2021] [Accepted: 02/17/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Nodular Fasciitis is a benign fibroblastic proliferation in soft tissues, which mostly occurs in the upper extremities, trunk, head and neck region. It is rarely reported to occur in the breast. CASE PRESENTATION Herein, we present sonograms of nodular fasciitis in the breast at different durations in three cases. In Case 1, we provided the longest follow-up time in all literatures. In Case 2 and Case 3, we provided the automated breast ultrasound finding of breast nodular fasciitis for the first time. CONCLUSION Nodular Fasciitis shows clinical features and ultrasonography findings are similar to those of breast cancer. For superficially located breast lesions with a single and rapid growth, nodular fasciitis may be considered in the differential diagnosis of benign entities resembling malignant tumors on breast imaging.
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Affiliation(s)
- Wanling Lin
- Department of Ultrasound, Affiliated Hangzhou First People's Hospital, Zhejiang University School of Medicine, 261 Huansha Rd, Shangcheng District, Hangzhou, 310006, Zhejiang, China
| | - Lingyun Bao
- Department of Ultrasound, Affiliated Hangzhou First People's Hospital, Zhejiang University School of Medicine, 261 Huansha Rd, Shangcheng District, Hangzhou, 310006, Zhejiang, China.
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Wang W, Huang Y, Wang C, Hong J, Ma C, Lin N, Ye Z, Yan S, Wu H. Intra-articular nodular fasciitis: a rare lesion case report and an updated review of the literature. BMC Musculoskelet Disord 2019; 20:5. [PMID: 30611237 PMCID: PMC6320623 DOI: 10.1186/s12891-018-2375-1] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/22/2018] [Accepted: 12/07/2018] [Indexed: 01/04/2023] Open
Abstract
BACKGROUND Nodular fasciitis is a benign proliferation of myofibroblasts that usually arises in subcutaneous tissues of the trunk, neck, head, and upper extremities of young adults. It is not reported to arise in the joints. CASE PRESENTATION In this report, we describe a rare case where nodular fasciitis occurred in an intra-articular location in the right knee of a 20-year-old man. The patient presented with 3-months' duration of knee pain without history of trauma to the extremity. Physical examination revealed pain, joint effusion, and limited range of motion (ROM) of the affected knee. Magnetic resonance imaging (MRI) showed a 2.5 × 2 × 1 cm lesion in front of the posterior cruciate ligament. Arthroscopically, the soft tissue mass was removed and pathologically diagnosed as a rare, benign, intra-articular nodular fasciitis. Symptoms resolved 1 month after the operation and no recurrence was found at the 6 months follow-up. CONCLUSION The present paper describes detailed characteristics of intra-articular nodular fasciitis and provides an updated comprehensive summary of 21 prior case reports.
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Affiliation(s)
- Wei Wang
- Department of Orthopaedic Surgery, The Second Affiliated Hospital, Zhejiang University School of Medicine, No.88 Jiefang Road, Hangzhou, 310009, People's Republic of China
| | - Yiting Huang
- Division of Reproductive Medicine & Infertility, The Second Affiliated Hospital, School of Medicine, Zhejiang University, 88#, Jiefang Rd., Hangzhou, Zhejiang, 310009, China
| | - Changxing Wang
- Department of Pathology, The Second Affiliated Hospital, School of Medicine, Zhejiang University, 88#, Jiefang Rd., Hangzhou, Zhejiang, 310009, China
| | - Jianqiao Hong
- Department of Orthopaedic Surgery, The Second Affiliated Hospital, Zhejiang University School of Medicine, No.88 Jiefang Road, Hangzhou, 310009, People's Republic of China
| | - Chiyuan Ma
- Department of Orthopaedic Surgery, The Second Affiliated Hospital, Zhejiang University School of Medicine, No.88 Jiefang Road, Hangzhou, 310009, People's Republic of China
| | - Nong Lin
- Department of Orthopaedic Surgery, The Second Affiliated Hospital, Zhejiang University School of Medicine, No.88 Jiefang Road, Hangzhou, 310009, People's Republic of China
| | - Zhaoming Ye
- Department of Orthopaedic Surgery, The Second Affiliated Hospital, Zhejiang University School of Medicine, No.88 Jiefang Road, Hangzhou, 310009, People's Republic of China
| | - Shiyuan Yan
- Department of Orthopaedic Surgery, The Second Affiliated Hospital, Zhejiang University School of Medicine, No.88 Jiefang Road, Hangzhou, 310009, People's Republic of China.
| | - Haobo Wu
- Department of Orthopaedic Surgery, The Second Affiliated Hospital, Zhejiang University School of Medicine, No.88 Jiefang Road, Hangzhou, 310009, People's Republic of China.
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Pohlodek K, Janík M, Mečiarová I, Ondriaš F. Pseudomalignant myositis ossificans in the breast: A case report. Mol Clin Oncol 2018; 8:749-752. [PMID: 29844904 DOI: 10.3892/mco.2018.1609] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2017] [Accepted: 03/22/2018] [Indexed: 12/27/2022] Open
Abstract
Myositis ossificans (MO) is characterized by abnormal heterotopic ossification formation, typically involving muscles, tendons, ligaments, fascia, and aponeurosis. It can be categorized into nonhereditary and hereditary types, with the latter being a distinct entity with a separate pathophysiology and treatment approach. The pathophysiology of MO formation remains to be fully elucidated. MO is most commonly observed in muscle tissue as a solitary lesion. The disease has been reported to occur in all ages, including the very young and in atypical locations, including hands, feet, ribs, head and neck. The present case report describes an unusual pseudomalignant form of MO in the breast. The authors discuss the clinical and morphological characteristics of the tumor and its treatment options.
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Affiliation(s)
- Kamil Pohlodek
- Second Department of Gynecology and Obstetrics, Comenius University of Bratislava, Faculty of Medicine, 82606 Bratislava, Slovakia
| | - Miroslav Janík
- Department of Thoracic Surgery, Slovak Medical University of Bratislava, 82606 Bratislava, Slovakia
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Moghimi M, Yazdian Anari P, Vaghefi M, Meidany A, Salehi H. Nodular Fasciitis of the Breast. IRANIAN JOURNAL OF RADIOLOGY 2016; 13:e18774. [PMID: 27127573 PMCID: PMC4841891 DOI: 10.5812/iranjradiol.18774] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/26/2015] [Revised: 07/25/2015] [Accepted: 09/20/2015] [Indexed: 11/16/2022]
Abstract
Nodular fasciitis of the breast is a rare benign pathology of soft tissue that is a consequence of fibroblastic hyperplasia within breast. It can mimic breast cancer clinically, radiologically, and histopathologically. A-43 year-old female with a painless mass within upper-lateral quadrant of her left breast complained of rapid and progressive growth during previous few days. No evidence of nipple discharge or sensation of pain was expressed. The mass was tender to palpation, but the size was too tiny to detect. The definitive diagnosis was established with sonography, which detected a hypoechogenic lesion, 10 mm in diameter. The excisional biopsy delivered a tissue composed of fusiform fibroblastic cells with bright ellipsoid-like nuclei and elevated nucleolus. Mitotic formations were also obvious. Low cellular and high cellular zones with hyaline fibrosis and erythrocyte accumulation existed, as well as a light lymphocytic infiltration. All of these features, in addition to adipocytic accumulation within the margins of this lesion, suggested a definitive diagnosis of Nodular fasciitis. The diagnosis of nodular fasciitis is difficult and often is indiscriminable from breast cancer, so paying close attention to this matter is critical.
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Affiliation(s)
- Mansour Moghimi
- Department of Pathology, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Pouria Yazdian Anari
- Medical Student Research Committee, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
- Corresponding author: Pouria Yazdian Anari, Medical Student Research Committee, Shahid Sadoughi University of Medical Sciences, Yazd, Iran. Tel: +98-3536230354; +98-9385101025, Fax: +98-3538113407, E-mail:
| | - Marzie Vaghefi
- Medical Student Research Committee, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Abbas Meidany
- Medical Student Research Committee, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Heidar Salehi
- Medical Student Research Committee, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
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Kang A, Kumar JB, Thomas A, Bourke AG. A spontaneously resolving breast lesion: imaging and cytological findings of nodular fasciitis of the breast with FISH showing USP6 gene rearrangement. BMJ Case Rep 2015; 2015:bcr-2015-213076. [PMID: 26698206 DOI: 10.1136/bcr-2015-213076] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Abstract
We report a case of nodular fasciitis of the breast in a 48-year-old woman who presented with a tender rapidly growing right breast lump. Ultrasound guided fine needle aspiration (FNA) of the solid mass was performed. Cytology was reported as atypical spindle cell neoplasm and the patient was referred to a breast surgeon at a tertiary institution for a definitive diagnosis and further management. Follow-up ultrasound showed partial regression and MRI, mammogram after 2-3 weeks confirmed spontaneous and total resolution of the lesion. Nodular fasciitis of the breast is rarely diagnosed on cytology alone and a histological diagnosis is usually required for a definitive diagnosis. However, in this case, the lesion spontaneously resolved prior to core biopsy or diagnostic open biopsy. The cytological features in conjunction with immunohistochemistry and the clinical history strongly suggest nodular fasciitis, which is further supported by a USP6 FISH positive result.
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Affiliation(s)
- Alexandra Kang
- Department of Anatomical Pathology, Sir Charles Gairdner Hospital, Nedlands, Western Australia, Australia
| | - Jayant Brij Kumar
- Department of Radiology, Sir Charles Gairdner Hospital, Perth, Western Australia, Australia
| | - Anitha Thomas
- Department of Anatomical Pathology, Sir Charles Gairdner Hospital, Nedlands, Western Australia, Australia
| | - Anita Geraldine Bourke
- Department of Radiology, Sir Charles Gairdner Hospital, Perth, Western Australia, Australia
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