Solitary dorsal paravertebral tumor: radiological and histopathological characterization of a pediatric case of nodular fasciitis

Authors

  • Javier Arredondo Montero Servicio de Cirugía Pediátrica. Hospital Universitario de Navarra. Servicio Navarro de Salud-Osasunbidea. Pamplona España. https://orcid.org/0000-0002-0943-6367
  • Teresa Dot Gómara Servicio de Anatomía Patológica. Hospital Universitario de Navarra. Servicio Navarro de Salud-Osasunbidea. Pamplona. España.
  • Sara Hernández-Martín Servicio de Cirugía Pediátrica. Hospital Universitario de Navarra. Servicio Navarro de Salud-Osasunbidea. Pamplona España. https://orcid.org/0000-0002-5038-225X
  • Mónica Bronte Anaut Servicio de Anatomía Patológica. Hospital Universitario de Araba. Osakidetza. Vitoria. España. https://orcid.org/0000-0002-3903-4844
  • Marta Montes Servicio de Anatomía Patológica. Hospital Universitario de Navarra. Servicio Navarro de Salud-Osasunbidea. Pamplona. España.

DOI:

https://doi.org/10.23938/ASSN.1025

Keywords:

Nodular fasciitis, Pediatrics, Dorsal, Paravertebral, Fascial tail sign

Abstract

Nodular fasciitis is a benign soft tissue lesion with rapid fibroblastic or myofibroblastic proliferation, rarely observed in pediatric patients. Here, we present the case of a seven-year-old boy with no relevant medical records, in whom an asymptomatic dorsal tumor was incidentally identified. Magnetic resonance imaging showed a left dorsal paravertebral lesion with hypointensity on T1, hyperintensity on T2, peripheral contrast enhancement, and the so-called fascial tail sign. Complete surgical resection of the lesion was achieved. The histopathological study showed a proliferation of spindle or stellate cells with nuclei without atypia in a myxoid or collagenized stroma. The immunohistochemical profile showed positivity for smooth muscle actin, muscle-specific actin antibody HHF35, and calponin. The lesion was diagnosed as nodular fasciitis, an entity with broad and complex differential diagnosis. Presence of specific radiological signs and adequate immunohistochemical characterization of the lesion help perform an accurate NF diagnosis.

Downloads

Download data is not yet available.

References

SÁPI Z, LIPPAI Z, PAPP G, HEGYI L, SÁPI J, DEZSŐ K et al. Nodular fasciitis: a comprehensive, time-correlated investigation of 17 cases. Mod Pathol 2021; 34(12): 2192-2199. https://doi.org/10.1038/s41379-021-00883-x

HSEU A, WATTERS K, PEREZ-ATAYDE A, SILVERA VM, RAHBAR R. Pediatric nodular fasciitis in the head and neck: evaluation and management. JAMA Otolaryngol Head Neck Surg 2015; 141(1): 54-59. https://doi.org/10.1001/jamaoto.2014.2797

SUH JH, YOON JS, PARK CB. Nodular fasciitis on chest wall in a teenager: a case report and review of the literature. J Thorac Dis 2014; 6(6): e108-110. https://doi.org/10.3978/j.issn.2072-1439.2014.05.18

SHIGA M, OKAMOTO K, MATSUMOTO M, MAEDA H, DABANAKA K, NAMIKAWA T et al. Nodular fasciitis in the mesentery, a differential diagnosis of peritoneal carcinomatosis. World J Gastroenterol 2014; 20(5): 1361-1364. https://doi.org/10.3748/wjg.v20.i5.1361

FABBRO MA, COSTA L, CIMAGLIA ML, DONADIO P, SPATA E, DANTE S. [Retroperitoneal nodular fasciitis: analysis of a case]. Pediatr Med Chir 1995; 17(5): 447-449.

DOMAZET I, NJIRIC N, JAKOVCEVIC A, BITUNJAC A, DOMAZET K, PAŠALIĆ I et al. Intraneural nodular fasciitis of the dorsal scapular nerve: case report and review of the literature. J Neurol Surg A Cent Eur Neurosurg 2021 [Epub ahead of print]. https://doi.org/10.1055/s-0041-1739218

QIU Y, HU X, HE X, ZENG WJ, ZHANG HY. Clinicopathological and genetic findings of infantile nodular fasciitis. Chin Med J (Engl) 2021; 134(22): 2768-2770. https://doi.org/10.1097/CM9.0000000000001727

PANDIAN TK, ZEIDAN MM, IBRAHIM KA, MOIR CR, ISHITANI MB, ZARROUG AE. Nodular fasciitis in the pediatric population: a single center experience. J Pediatr Surg 2013; 48(7): 1486-1489. https://doi.org/10.1016/j.jpedsurg.2012.12.041

WU SY, ZHAO J, CHEN HY, HU MM, ZHENG YY, MIN JK et al. MR imaging features and a redefinition of the classification system for nodular fasciitis. Medicine (Baltimore) 2020; 99(45): e22906. https://doi.org/10.1097/MD.0000000000022906

TOMITA S, THOMPSON K, CARVER T, VAZQUEZ WD. Nodular fasciitis: a sarcomatous impersonator. J Pediatr Surg 2009; 44(5): e17-e19. https://doi.org/10.1016/j.jpedsurg.2009.01.047

CHU CL, LU YJ, LEE TH, JUNG SM, CHU YC, WONG HF. Concomitant spinal dural arteriovenous fistula and nodular fasciitis in an adolescent: case report. BMC Pediatr 2022; 22(1): 30. https://doi.org/10.1186/s12887-021-03032-0

Published

2022-12-28

How to Cite

Arredondo Montero, J., Dot Gómara, T., Hernández-Martín, S., Bronte Anaut, M., & Montes, M. (2022). Solitary dorsal paravertebral tumor: radiological and histopathological characterization of a pediatric case of nodular fasciitis. Anales Del Sistema Sanitario De Navarra, 45(3), e1025. https://doi.org/10.23938/ASSN.1025

Most read articles by the same author(s)