NODULAR FASCIITIS OF THE VULVA - A STUDY OF 6 CASES AND LITERATURE-REVIEW

We report six cases of histologically typical nodular fasciitis that e ach presented as a vulvar soft tissue mass. The diagnosis of nodular f asciitis had not been considered by the referring pathologist in any o f the five consultation cases. The patients' ages ranged from 7 to 51 years (mean 34). The lesion was confined to the labia in the four case s in which a specific site was noted, The masses ranged from 1.5 to 3. 5 cm (mean 2.2) in maximal dimension. All of them were locally excised , and the resection margins were involved in each case. In addition to the typical features of nodular fasciitis, a noteworthy finding in tw o of the six cases was the presence of cleftlike spaces lined by plump synovial-like cells, Follow-up ranged from 3 months to 7 years (mean 24 months). A local recurrence developed in one patient at 4 months an d was reexcised; there have been no recurrences in any other case. The literature contains only five additional examples of vulvar nodular f asciitis. Although all were pathologically typical, the diagnosis was often not considered, evidently because of the unusual location. Aware ness that nodular fasciitis may occur in the vulva and the features th at allow its distinction from other mesenchymal ''tumors'' occurring a t this site will facilitate its correct diagnosis.