A rapidly progressing periorbital mass in an infant: Fasciitis Nodularis

Nodular fasciitis is a benign, rapidly growing proliferation of fibroblasts, which is histologically difficult to distinguish from neoplasms. In several reports, as many as half of all cases have been initially misdiagnosed as a fibrosarcoma or some other malignancy. Although the head and neck is a region of predilection in infants and children, only eight periocular lesions have previously been reported in paediatric patients. We present a case of nodular fasciitis which occurred in the periorbital region in a 1½-year-old girl. The process was excised locally in order to perform a biopsy. The mass was initially classified as a sarcoma but subsequently as infantile fibromatosis. Only after a thorough review of the case and four independent pathological consultations was the final diagnosis of nodular fasciitis confirmed. No further treatment was scheduled. Although the primary surgical removal of the tumour was not radical, no recurrence was observed during a 3-year follow-up period.