Case Report
Copyright ©The Author(s) 2020. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Dec 6, 2020; 8(23): 6144-6149
Published online Dec 6, 2020. doi: 10.12998/wjcc.v8.i23.6144
Occipital nodular fasciitis easily misdiagnosed as neoplastic lesions: A rare case report
Teng Wang, Guang-Cai Tang, Han Yang, Jian-Kun Fan
Teng Wang, Guang-Cai Tang, Han Yang, Jian-Kun Fan, Department of Radiology, The Affiliated Hospital of Southwest Medical University, Luzhou 646000, Sichuan Province, China
Author contributions: Wang T consulted the literature, collected the images, and wrote this paper; Yang H and Fan JK collected the clinical data and consulted the literature; Tang GC designed the research and revised the paper.
Informed consent statement: Informed written consent was obtained from the patient.
Conflict-of-interest statement: The authors declare that they have no conflict of interest to disclose.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Guang-Cai Tang, MD, Chief Doctor, Director, Full Professor, Department of Radiology, The Affiliated Hospital of Southwest Medical University, No. 23 Taiping Street, Luzhou 646000, Sichuan Province, China. 168345315@qq.com
Received: June 28, 2020
Peer-review started: June 28, 2020
First decision: September 23, 2020
Revised: October 3, 2020
Accepted: October 20, 2020
Article in press: October 20, 2020
Published online: December 6, 2020
Processing time: 159 Days and 3.3 Hours
Abstract
BACKGROUND

Nodular fasciitis (NF) is a benign disease originating from fascial tissue and most commonly occurs in the extremities, followed by the trunk, head, and neck. NF of the head and neck occurs mainly in the face and neck, and it has not been reported in the occipital region.

CASE SUMMARY

A 30-year-old man was admitted because of a mass in the left occipital region. Imaging examination revealed a soft tissue nodule in the left occipital area. An enhanced magnetic resonance imaging scan showed characteristic inverted target and fascial tail signs. Histopathological analysis showed a large amount of spindle cell proliferation, and immunohistochemistry showed positive expression of SMA in the spindle cells in the lesion. Finally, nodular fasciitis was diagnosed.

CONCLUSION

NF of the head and neck is rare, but the possibility of NF should be considered when nodules or masses with rapid subcutaneous growth are found and tenderness in the head and neck is present. Imaging examination, in combination with clinical manifestations and histopathological examination, can improve the diagnostic accuracy for the disease. After diagnosis, local surgical resection is the first choice of treatment.

Keywords: Nodular fasciitis; Fibromatous hyperplasia; Radiology; Computed tomography; Magnetic resonance imaging; Case report

Core Tip: Nodular fasciitis is a benign disease originating from fascial tissue and often occurs in the extremities. We report a case of nodular fasciitis in the occipital region. Combined with clinical and pathological findings, we analyzed its imaging findings to improve the understanding of this disease.