Rapidly growing nodular fasciitis in the cheek of an infant: case report of a rare presentation

Nodular fasciitis is a benign proliferative spindle-cell lesion found in the subcutaneous fascia that presents as a rapidly growing mass with rich cellularity and mitotic activity, leading to it frequently being mistaken for a sarcoma. Histomorphologic features and immunohistochemical profile are useful in proper diagnosis. The treatment is complete excision, and recurrence is uncommon. A rare presentation and treatment of nodular fasciitis in the cheek of an infant is described here. The lesion was resected by direct transcutaneous approach, and the skin was closed with 2 layers of purse-string polydioxanone sutures followed by fast-absorbing gut sutures to reapproximate the epidermis. Postoperatively, the patient had a wound dehiscence on the cheek, which healed secondarily with wound care. A small area of palpable tumor unable to be resected remained stable after 4 months of follow-up, and facial nerve function was preserved. Although infrequent in both children and the oral mucosa, nodular fasciitis should be considered in the differential diagnosis of facial tumors in infants and young children.