Nodular fasciitis is a benign proliferation of fibroblasts and myofibr
oblasts in the subcutaneous tissues. The lesions are generally small a
nd solitary, arising commonly in the upper extremities of adults and i
n the head and neck region of infants and children. A history of traum
a may precede these reactive lesions, but their cause is unknown. The
rapid growth, abundant cellularity, and mitotic activity frequently ca
use these lesions to be misdiagnosed as sarcomas. Local excision is th
e treatment of choice for these generally nonrecurring lesions. A case
report, differential diagnosis, and review of the literature are pres
ented. Physicians need to be aware of this clinical entity and to work
closely with pathology consultants in confirming this difficult diagn
osis.