Nodular fasciitis is a benign growth that can occur in the skin, muscle, or connective tissues. It may cause tenderness and can be misdiagnosed as a cancerous sarcoma. Treatment may involve observation or surgical removal. The cause is not always clear, but it is known to occur in children and adults. Symptoms may include a lump, and scans or biopsies may be done to determine the nature of the growth. Treatment is typically successful, and recurrence is rare.
Nodular fasciitis refers to a condition in which a benign growth occurs under the skin, in muscle, or in connective tissues. This may have few symptoms, although in about half of the cases, there may be some tenderness when the growth is touched. Doctors suggest that tissue injury could be a possible cause of this condition. Because the node can rapidly increase in size, it is sometimes misdiagnosed as a cancerous sarcoma and scans or biopsies may be done to rule it out. Treatment may then consist of observing the node for further development or having it surgically removed.
The types of material that can make up a nodular fasciitis growth can include water, fibers, or mucus. These tend to develop as a response to some external injury or inflammation occurring within the body. Sometimes they occur in the absence of a clear cause.
Commonly, the growths form just under the skin, but sometimes these benign tumors also develop in the muscles or joints. Nodular muscle fasciitis lesions tend to grow faster and are more likely to resemble sarcomas. The size of these knots can vary and can range from a few hundredths of an inch (a few millimeters) to 0.39-1.97 inches (1-5 centimeters) in diameter.
While the cause isn’t always clear, nodular fasciitis is known to occur in children or adults and most often affects people in the first few decades of adulthood. If children develop this condition they often get growths on their head or neck. Conversely, knots tend to occur more often on the forearms in adults. In adulthood, both sexes develop these growths equally frequently, but boys are more likely to get these growths than girls. Nodular fasciitis doesn’t always develop in the most expected places or ways, and there are reports of rare cases where it has developed on the breasts, back and legs, or exceeded the expected size.
Symptoms of this condition may include a noticeable lump, possibly as a result of injury or inflammation. Sometimes this lump is swollen or painful, but about half of people with nodular fasciitis feel no discomfort at all. Any rapidly expanding growth requires medical attention to rule out malignant tumors.
Doctors cannot tell by feeling whether a lump is benign or malignant. Instead, they may choose to have scans such as magnetic resonance imaging (MRI) or a computed tomography (CT) scan. These alone cannot indicate whether a growth is nodular fasciitis or some other more dangerous condition. The best method to determine this is the biopsy of the node.
Once a growth has been identified as nodular fasciitis, doctors may choose not to treat it, as they sometimes resolve without intervention. Alternatively, the entire node can be removed, which is a good option if it causes discomfort or if the growth is unsightly. Many patients respond well to excision, and over 90% of individuals experience no recurrence. Treatment is typically done on an outpatient basis, and individuals are quickly able to resume normal activities.
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