Giant nodular fasciitis originating from the humeral periosteum: A case report

Table 1 Published studies reporting periosteal fasciitis

Ref.	Number of cases	Sex	Age (yr)	Symptom presence and duration	Location	Treatment	Size (cm)	USP6 gene	Follow-up (mo)	Recurrence	Injury
Lääveri et al[11], 2017	1	Female	7	No	Mandible	Local resection	3	Yes	36	No	No
Rankin et al[12], 1991	1	Female	39	No	Hand	Local resection	5	NA	10	No	No
Mostofi et al[13], 1987	1	Male	46	No	Mandible	Local resection	3	NA	30	No	No
Sato et al[14], 1981	1	Male	31	Pain for 2 mo	Maxillary	Local resection	4	NA	8	No	No
McCarthy et al[15], 1976	1	Male	40	No	Ring finger	Amputation	NA	NA	12	No	No
Johnson and Lawrence[16], 1975	1	Male	38	Pain and swelling for 3 mo	Metacarpal and ring finger	Local resection	NA	NA	12	No	No
Goncalves[17], 1974	1	Female	23	Pain and swelling for 2 wk	Index finger	Amputation	NA	NA	60	No	No
Lumerman et al[18], 1972	1	Female	31	Pain for 3 d	Mandible	Local resection	2	NA	30	No	No
Carpenter and Lublin[19], 1967	1	Female	32	Pain and swelling for 7 mo	Proximal and middle phalanges, ring finger	Amputation	NA	NA	12	No	No
Mallory[20], 1933	1	Female	28	Pain, swelling for 4 wk	4th and 5th metacarpals	Incomplete local resection	NA	NA	12	No	No

NA: Not available.

Table 2 Primary differential diagnosis

Tumor type	Epidemiology	Clinical features	Size	Histopathology	Immunophenotype	Genetics
Nodular fasciitis	Young adults, no gender difference	Grows rapidly, painless, recurrence is rare	Median size, ≤ 2 cm (always < 5 cm)	Spindle-shaped fibroblasts, growth in S- or C- shaped, interstitium is loose and myxoid, visible exosmosis of erythrocytes	Positive: SMA, Calponin, CD10; negative: S100, CD34, nuclear β-catenin	MYH9–USP6 gene fusion
Low-grade fibromyxoid sarcoma	Typically affect young adults, no gender difference	Slow growth, no pain, easy recurrence	Median size, 5 cm (1-20 cm)	Original glue and myxoid region are mixed, spindle cell, small blood vessels, early formation of collagen rosettes	EMA positive from focally to 80%, MUC4 positive has high sensitivity and specificity	FUS-CREB3L2 or FUS-CREB3L1 gene fusion
Low-grade myofibroblastic sarcoma	Predominantly in adults, 40-50 yr see more, slight predominance in males	Enlarging mass, painless, easy recurrence	Median size, 4 cm (1.4-17 cm)	Diffusely infiltrative growth, spindle cells arranged in a storiform pattern or fascicles	Positive: actin, desmin, calponin, CD34 (focal); negative: S100, nuclear β-catenin	Only one showed a circular chromosome
Low-grade myxofibrosarcoma	Elderly patients, over 60 yr, slight predominance in males	Slowly enlarging, painless, easy recurrence	Larger volume (range variable)	Spindle cells, mild atypia, curvilinear thin-walled blood vessels, pseudolipoblasts	Positive: SMA, negative: Desmin and histiocyte-specific markers	No specific aberration