Nodular fascitis in the zygomatic area. Case report and review of the literature

The authors report a clinical case of nodular fasciitis in the zygomatic area. Although this tumor-like proliferation occurs very rarely in the maxillofacial region, careful diagnosis based on histologic examination must distinguish it from neoplastic lesions such as fibrosarcoma with which the disorder shares certain histologic features. The case is compared with others described in the literature. In June 1996 a 12-year-old girl presented at our unit with swelling of the zygomatic region and positive history for trauma to the area. Palpation of the soft tissues detected a nodular formation about 1.5 cm in diameter. Echography and magnetic resonance imaging confirmed the presence of a nodular proliferation above the bone surface. The nodule was surgically removed by skin excision, and histologic examination of the specimen confirmed the diagnosis of nodular fascitis. The etiology of the lesion was thought to be a reaction to trauma, in agreement with data reported in the literature. Nodular fasciitis is a benign, non-recurrent lesion; however, its rapid growth and the histologic features it shares with more aggressive tumors such as fibrosarcoma call for careful differential diagnosis. As in our case, a history of previous trauma to the involved area can aid in establishing a correct diagnosis