Publication:

Atypical location of nodular fasciitis in a pediatric patient: a case report and literature review

Nodular fasciitis (NF) is a benign, rapidly growing soft tissue lesion that can mimic malignant neoplasms. First described in 1955, it is commonly seen in adults but remains rare in pediatric populations, particularly in the orbital region. A comprehensive literature review was conducted, analyzing all reported cases of orbital NF between 1990 and 2022. Key parameters included patient demographics, clinical presentation, histopathological findings, treatment approaches, and outcomes. Twenty cases were identified, with an equal distribution of male and female patients. The most common clinical presentation was a rapidly growing, painless orbital mass. Histopathological analysis revealed a spindle cell proliferation with myxoid stroma, positive immunostaining for actin and vimentin, and variable expression of other markers. Surgical excision was the primary treatment, with no reported recurrences or postoperative complications. Although rare, orbital NF should be considered in the differential diagnosis of pediatric soft tissue tumors. Awareness of its benign nature is crucial to avoid unnecessary aggressive treatments. Surgical excision remains the treatment of choice, although spontaneous regression has been reported. Further studies are needed to elucidate its etiology and optimize management strategies.