Introduction
Nodular fasciitisis a rare non-cancerous tumor. It represents 0.025 percent of all tumor masses. Nodular fasciitis is a condition that affects the connective tissue of the fascia. The fascia is a layer of tissue that covers and protects many of your body's structures, such as muscles and tendons. Nodular fasciitis occurs when there is inflammation in this layer of connective tissue. It can occur in any of the soft tissues in the body. It might appear similar to malignant (cancerous) tumors, making diagnosing the condition difficult for medical professionals. Accurate diagnosis may need additional tests and investigations to avoid misdiagnosis and unnecessary treatments.
What Is Nodular Fasciitis?
Nodular fasciitis is an inflammation of the fascia. Fascis is the connective tissue layer underneath the skin that covers and surrounds the muscles, blood vessels, and nerves. Nodular fasciitis is a tumor growth of this fascia extending up to three centimeters in diameter. This is a solitary and fast-growing tumor that may occasionally be painful. Nodular fasciitis is also called pseudosacromatous fasciitis, proliferative fasciitis, or infiltrative fasciitis. It mainly affects the mid-age groups from 20 to 40 years old. However, it may also occur in other age groups that affect both genders.
What Are the Causes of Nodular Fasciitis?
Researchers and medical professionals are still studying to determine the exact cause of nodular fasciitis. Though the cause of nodular fasciitis remains unknown, it is believed that fascia cells may get triggered by an injury or infection in that area. This may cause the cells to proliferate and cause a massive tumor, causing nodular fasciitis.
What Are the Symptoms of Nodular Fasciitis?
Nodular fasciitis is a soft tissue overgrowth of the cells of the fascia lying underneath the skin. Clinical symptoms are insufficient to diagnose and distinguish it from other malignant tumors. The following are the symptoms that indicate nodular fasciitis:
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This is a fast-growing tumor and may grow in size rapidly.
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It is one solid tumor growth, oval or round. Its margins around the growth may be irregular.
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On touching, it is firm.
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Nodular fasciitis may not be painful. However, on touching it, it may feel tender and discomforting.
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This tumor does not spread to other tissues like the malignant ones.
Where Does Nodular Fasciitis Occur?
Since fascia is present throughout the body, nodular fasciitis can occur anywhere, including the mouth. According to recent studies, nodular fasciitis mainly occurs in the forearm, thigh, and upper arm, ranging from 12 to 27 percent. According to a recent survey, nodular fasciitis mainly occurred in the arms (34 percent), head and neck region (24 percent), trunk (21 percent), and legs (14 percent).
How Is Nodular Fasciitis Diagnosed?
Nodular fasciitis has characteristics similar to malignant tumors, making diagnosing the condition difficult. It can resemble spindle cell sarcoma, fibromatosis, fibro histiocytoma, benign nerve sheath tumors, and pleomorphic adenoma. Hence, additional investigations may be required to diagnose the condition properly. The doctor begins by taking a complete physical and family history and thoroughly diagnosing the tumor mass. The doctor may then call for additional scans like magnetic resonance imaging (MRI) and computed tomography (CT) to help identify additional characteristics of nodular fasciitis. Fine needle aspiration cytology (FNAC) may be performed, then sent to the laboratory for a complete tissue analysis under the microscope (tissue histology) to give a definitive diagnosis. Sometimes, the condition may still not be diagnosed and only confirmed once surgically removed.
How Is Nodular Fasciitis Treated?
Sudden swelling and inflammation of the tissue caused by injury or infection can cause nodules in the soft tissues. The pain that results from nodular fasciitis may be persistent and localized around the affected area, and swelling typically occurs along with it. Treatment of this condition will often include a combination of rest and treatment with anti-inflammatory medications. Antibiotics may also be prescribed if an underlying bone injury is present, as these infections typically form along bone lines. Excessive use of steroid creams may also be prescribed to help bring down swelling. However, this has not been shown to help much when treating the condition. Surgery is usually not required for treatment, but if internal organs become affected, surgery may be necessary to remove growths close to vital organs. Treatment of nodular fasciitis depends on the location, size, and symptoms. It is also true that, in some cases, nodular fasciitis may resolve on its own. The following are the treatments for nodular fasciitis:
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Monitoring of the Tumor Mass - Since some cases of nodular fasciitis may resolve independently, the doctor may not start the treatment immediately and keep it under observation to see if the mass is growing.
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Surgery - Surgical removal of the tumor mass may be required if the symptoms involve discomfort, pain, and harming the surrounding tissues. In most cases, the tumor mass does not reoccur after the surgery. The surgery may involve complete removal or partial removal of the mass. The mass may be partially removed to protect some tissue or nerve.
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Pinhole Laser - Carbon dioxide laser (CO2 laser) is a treatment option to treat facial nodular fasciitis. The main advantage of this procedure is that it does not cause any post-surgery scars. However, it is only done once the condition is accurately diagnosed as nodular fasciitis ruling out other malignant cancers.
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Medications - Oral or injectable corticosteroids are given for better prognosis and fewer recurrences. Steroid medications also require ruling out malignancy conditions.
Conclusion
Nodular fasciitis is a rare form of inflammation or infection of the fascia, the thick connective tissue surrounding muscles. Noticing nodular growth anywhere in the body may indicate several conditions similar to malignant ones. In that case, seeing a doctor as soon as possible is extremely important. Early diagnosis and prompt treatment give a better prognosis. And since this condition is relatively harmless, does not spread, and does not carry any health risks, there is no harm in being checked out by a professional.
