Yanagisawa Akihiro, Okada Hideki
Department of Plastic and Reconstructive Surgery, National Hospital Organization Saga National Hospital, Saga, Japan.
J Craniofac Surg. 2008 Jul;19(4):1167-70. doi: 10.1097/SCS.0b013e318176ac1a.
Nodular fasciitis is a benign reactive proliferation that is frequently misdiagnosed as a sarcoma. This article describes a case of nodular fasciitis of 6-month duration located in the cheek, which degenerated and spontaneously regressed after biopsy. The nodule was fixed to the zygoma but was free from the overlying skin. The mass was 3.0 cm in diameter and demonstrated high signal intensity on T2-weighted magnetic resonance imaging. A small part of the lesion was biopsied. Pathological and immunohistochemical examinations identified the nodule as nodular fasciitis with myxoid histology. One month after the biopsy, the mass showed decreased signal intensity on T2-weighted images and measured 2.2 cm in size. The signal on T2-weighted images showed time-dependent decreases, and the mass continued to reduce in size throughout the follow-up period. The lesion presented as hypointense to the surrounding muscles on T2-weighted images and was 0.4 cm in size at 2 years of follow-up. This case demonstrates that nodular fasciitis with myxoid histology can change to that with fibrous appearance gradually with time, thus bringing about spontaneous regression. Degeneration may be involved in the spontaneous regression of nodular fasciitis with myxoid appearance. The mechanism of regression, unclarified at present, should be further studied.
结节性筋膜炎是一种良性反应性增生，常被误诊为肉瘤。本文描述了一例位于脸颊、病程6个月的结节性筋膜炎病例，该病例在活检后发生退变并自发消退。结节与颧骨固定，但与上方皮肤不相连。肿块直径3.0 cm，在T2加权磁共振成像上表现为高信号强度。对病变的一小部分进行了活检。病理和免疫组化检查确定该结节为黏液样组织学的结节性筋膜炎。活检后1个月，肿块在T2加权图像上信号强度降低，大小为2.2 cm。T2加权图像上的信号呈时间依赖性降低，在整个随访期间肿块持续缩小。在随访2年时，病变在T2加权图像上相对于周围肌肉呈低信号，大小为0.4 cm。该病例表明，黏液样组织学的结节性筋膜炎可随时间逐渐转变为纤维样外观，从而导致自发消退。退变可能参与了黏液样外观结节性筋膜炎的自发消退。目前尚不清楚的消退机制应进一步研究。
