Published online Feb 16, 2022. doi: 10.12998/wjcc.v10.i5.1572
Peer-review started: November 30, 2020
First decision: September 28, 2021
Revised: October 9, 2021
Accepted: January 6, 2022
Article in press: January 6, 2022
Published online: February 16, 2022
Processing time: 441 Days and 4.6 Hours
Nodular fasciitis (NF) is a self-limiting tumor that mostly occurs in the subcutaneous superficial fascia. NF originating from the appendicular periosteum is extremely rare. A large NF lesion of periosteal origin can be misdiagnosed as a malignant bone tumor and may cause overtreatment.
A right axillary mass was found in a 46-year-old man and was initially diagnosed intraoperatively as low-grade sarcoma, but later diagnosed as NF after post-resection histopathological evaluation. Furthermore, fluorescence in situ hybridization analysis revealed a USP6 gene rearrangement that confirmed the diagnosis. To the best of our knowledge, this is the first case of NF in the humeral periosteum.
NF poses a diagnostic challenge as it is often mistaken for sarcoma. Postoperative histopathological examination of whole sections can be combined with immunohistochemical staining and, if necessary, the diagnosis can be confirmed by molecular detection, and thus help avoid overtreatment.
Core Tip: This article provides a comprehensive overview of the clinicopathological, immunohistochemical, and molecular features of nodular fasciitis originating from the humeral periosteum. To date, this is the first report of nodular fasciitis originating from the humeral periosteum and this type of research is critical to further our understanding of these lesions and advance pathological diagnoses.