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KMID : 0829220110350020107
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Korean Journal of Oral and Maxillofacial Pathology
2011 Volume.35 No. 2 p.107 ~ p.112
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A Case of Pseudosarcomatous Nodular Fasciitis in Cervical Area Mimicking Metastatic Tumor
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Kim Min-Geun
Song Ji-Young
Kim Seong-Gon
Park Young-Wook
Yoon Jong-Sang
Lee Suk-Keun
Lee Sang-Shin
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Abstract
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The present case occurred in the cervical area of 51 years old male, who was generally healthy but recently complained of cervical swelling with mild pain. The tumor recently grew rapidly for 5 months. He was referred from local hospital in the diagnosis of metastatic tumor in cervical lymph. In the biopsy procedure, the tumor mass was ill-defined and not associated with cervical lymph node. The microsection showed a highly proliferative fibrous tissue infiltrative growth into the periphery. The spindle tumor cells were stained red in Masson trichrome stain, and strongly positive for PCNA and β-catenine, and partly positive for α-smooth muscle actin (α-SMA), but negative for S-100 and desmin. The differential diagnosis in primary biopsy examination was made as leiomyosarcoma, malignant schwannoma, and mesenchymal sarcoma. Under the diagnosis of sarcoma the patient was operated for tumor resection including cervical lymph nodes. The tumor mass was tightly attached on the lower border of left mandibular body. After the surgical operation the tumor tissue was more investigated with further immunohistochemical stainings, and discussed with several pathologists in Gangneung area. Finally the tumor was turned out to be a nodular fasciitis with pseudosarcomatous proliferation, and also confirmed that the pseudosarcomatous spindle cells belonged to the myofibroblasts originated from the fibrovascular fascial tissue. The present study demonstrated a rare case of nodular fasciitis, which should be differentially diagnosed from the malignant head and neck tumors.
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KEYWORD
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Nodular fasciitis, Pseudosarcomatous proliferation
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