Nodular fasciitis: Clinical characteristics and preoperative diagnosis

Background and Purpose: Because of its rapid growth, hypercellularity, and brisk mitotic rate, nodular fasciitis (NF) is probably the most common benign mesenchymal tumor that is misdiagnosed as a sarcoma, often leading to unnecessary and overly aggressive therapy. Methods: This retrospective study evaluated the characteristics of 92 well-documented cases of NF treated from 1988 to 2001. Gender, age, location, size and clinical symptoms were analyzed, as was the accuracy of preoperative diagnosis. Results: Females were predominant (male-to-female ratio, 1:1.71; p = 0.006, binomial distribution). Accurate preoperative diagnosis was made in only 14.1%, but this rate improved in recent years (p = 0.034, chi-squared test for trend). The pathologic subtype of NF did not correlate with the duration of the lesion. Conclusions: Clinicians should include NF in the differential diagnosis of rapidly growing subcutaneous tumors and not rush to overly aggressive therapy.