A case of nodular fasciitis of the chest wall

1998 
: We present a case of nodular fasciitis of chest wall origin. A 62-year-old woman visited our hospital because of a rapidly growing hard tumor fixed to her right chest wall, measuring 7 x 8 cm in size. Although incisional biopsy specimen revealed that the tumor was suggestive of nodular fasciitis, the possibility that the tumor had a malignant component could not be excluded. Total excision of the mass with combined resection of 3rd, 4th, 5th ribs was performed to establish the histological diagnosis and treatment plan. We believe that the tumor proved to be malignant by excisional biopsy, should then undergo further excision with sufficient surgical margin. Nodular fasciitis may be misdiagnosed as a sarcoma due to its rich cellularity, mitotic activity and poorly circumscribed nature. Awareness of the histological features of nodular fasciitis, and its predilection for presenting as a rapidly growing mass, should decrease the likelihood of misdiagnosis and the attendant risk of over surgery.
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