Nodular fasciitis of the head and neck in children. A deceptive lesion.

Nodular fasciitis represents a discrete, benign, presumably reactive proliferation of fibroblasts. However, its rapid rate of growth and a sarcomatous histologic appearance are often deceptive. Multiple pathologic reviews are frequently conducted in an attempt to distinguish nodular fasciitis from other lesions. Such confusion is especially problematic in the pediatric otolaryngic population in which nodular fasciitis is not commonly encountered and mesenchymal malignancies of the head and neck are of fundamental concern. Between 1976 and 1988, 12 cases of nodular fasciitis were diagnosed at the Children's Hospital of Philadelphia (Pa). Six children presented with head and neck lesions and ranged from 6 to 13 years of age. The clinical and histopathologic features of these cases are reviewed.