NODULAR FASCIITIS - SPONTANEOUS RESOLUTION FOLLOWING DIAGNOSIS BY FINE-NEEDLE ASPIRATION

Nodular fasciitis can be histologically mistaken for a sarcoma. Typica l cases are less than 5 cm and enlarge rapidly over days or weeks befo re diagnosis. The natural history of nodular fasciitis is unknown, sin ce the diagnosis is usually based on excised lesions. Fine-needle aspi ration of nodular fasciitis has been described, and features benign-ap pearing spindle cells (singly and in groups), collagen, and myxoid mat erial. We describe 11 cases in which nonsurgical observation led spont aneously to complete resolution. Our study includes 7 males and 4 fema les (24 to 73 years of age; median = 42). Lesions were located in the arm (4), thigh (3), temporal area (2), breast (1) and the parotid (1) and ranged from 0.5 to 5.0 cm. (median = 1.5). They had been present f or from less than 1 to 4 weeks (median = 2). In 9 cases, spontaneous r esolution occurred in from 3 to 8 weeks (median = 4). Two other patien ts were lost to follow-up for up to 11 months, after which resolution was noted Small palpable masses in the subcutaneous soft tissues which evolve over a short period of time and show the cytologic features of nodular fasciitis should be managed nonsurgically. If resolution does not occur within a few weeks, surgery can then be performed.