A huge nodular fasciitis in parapharygneal space in a 7-year-old girl: a case report and review of literature

Nodular fasciitis (NF) is a benign and reactive fibroblastic growth extending from the superficial fascia into the subcutaneous tissue or muscle, with a morbidity of less than 20% in children. We report a case of a 7-year-old girl presented with a 3-month history of snore and mouth breathing. Image...

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Published inInternational journal of clinical and experimental pathology Vol. 7; no. 12; pp. 9023 - 9027
Main Authors Xie, Shumin, Liu, Wei, Xiang, Yuyan, Dai, Yinghuan, Ren, Jihao
Format Journal Article
LanguageEnglish
Published United States e-Century Publishing Corporation 01.01.2014
Subjects
Biomarkers - analysis
Biopsy
Case Report
Child
Fasciitis - complications
Fasciitis - metabolism
Fasciitis - pathology
Fasciitis - surgery
Female
Humans
Immunohistochemistry
Magnetic Resonance Imaging
Mouth Breathing - etiology
Pharyngeal Diseases - complications
Pharyngeal Diseases - metabolism
Pharyngeal Diseases - pathology
Pharyngeal Diseases - surgery
Pharynx - chemistry
Pharynx - pathology
Pharynx - surgery
Snoring - etiology
Tomography, X-Ray Computed
Treatment Outcome
parapharygneal space
Nodular fasciitis
children
solitary fibrous tumor
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Summary:Nodular fasciitis (NF) is a benign and reactive fibroblastic growth extending from the superficial fascia into the subcutaneous tissue or muscle, with a morbidity of less than 20% in children. We report a case of a 7-year-old girl presented with a 3-month history of snore and mouth breathing. Image findings demonstrated a large soft-tissue mass in the right parapharyngeal space. The lesion was successfully eradicated by surgical removal. Pathological analysis established NF as the final diagnosis. Histopathological findings were notable for a reactive spindle-cell process composed of proliferative fibroblasts with extravasated red blood cells and interstitial edema. Immunohistochemical stains showed that the lesional cells were positive for smooth muscle actin (SMA), muscle-specific actin (HHF35), and epithelial membrane antigen (EMA), and negative for S100 protein. No clinical evidence of recurrence was noticed after 2 months of follow-up. Being the first report of NF in the parapharyngeal space of a child, this rare pediatric case points out the importance for otolaryngologists to keep NF in mind for differential diagnosis to avoid unnecessary wide resection.
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ISSN:1936-2625