Scopus
🔓 Açık Erişim
Nodular fasciitis of the finger with bone erosion: unusual behavior mimicking malignancy
Egyptian Journal of Radiology and Nuclear Medicine · Aralık 2025
Makale Bilgileri
DergiEgyptian Journal of Radiology and Nuclear Medicine
Yayın TarihiAralık 2025
Cilt / Sayfa56
Scopus ID2-s2.0-105022202972
Erişim🔓 Açık Erişim
Özet
Background: Nodular fasciitis (NF) is tumor-like, non-neoplastic disease. Objective: Bone erosion due to nodular fasciitis is extremely rare and may resemble a malignant neoplasm radiologically. The aim of the current work was to present a rare case of nodular fasciitis of the finger associated with bone erosion, emphasizing its radiological and pathological features that may mimic malignancy, and to contribute to the differential diagnosis of similar lesions. Case presentation: A 38-year-old man presented with a gradually enlarging, non-tender mass on the dorsal side of the right hand, associated with mild discomfort and restricted movement. Physical exam revealed a 1.5 cm mass adjacent to the second metacarpal bone. The ultrasound showed a 20 × 14 mm hypoechoic nodular lesion between the second and third metacarpal bones, closely related to the distal second metacarpal. X-ray revealed a well-defined, radiolucent lesion in the distal metaphysis without periosteal reaction. Computed tomography (CT) confirmed a lytic bone lesion with soft tissue involvement, but no aggressive features were observed. Magnetic resonance imaging (MRI) showed a soft tissue mass with internal cystic areas, heterogeneous contrast enhancement, surrounding soft tissue involvement, and bone marrow edema. Excision was performed due to a broad differential diagnosis, including enchondroma protuberance and tenosynovial giant cell tumor. Histological analysis showed a well-circumscribed nodular lesion composed of spindle cells in a myxoid-collagenous matrix, consistent with nodular fasciitis. Conclusions: Nodular fasciitis is a rare, benign, and rapidly growing soft tissue lesion that can mimic malignancy both clinically and radiologically, posing a diagnostic challenge. Although it typically arises in subcutaneous tissues of the upper extremities, its occurrence in the hand, particularly with bone involvement, is sporadic. Imaging findings are often nonspecific, with variable ultrasound, CT, and MRI features that may resemble aggressive or malignant lesions. This case highlights an unusual presentation of NF with bone invasion in the hand, emphasizing the importance of including NF in the differential diagnosis of benign-appearing but locally aggressive lesions. Marginal excision remains the treatment of choice, with low recurrence rates when complete resection is achieved.
Yazarlar (5)
1
Esra Soyer Guldogan
ORCID: 0000-0002-9251-5241
2
Kursat Duzenli
ORCID: 0009-0000-5108-6084
3
Tuba Akdag
ORCID: 0000-0001-5902-5913
4
Omer Ozel
ORCID: 0000-0002-6859-017X
5
Selim Safali
Anahtar Kelimeler
Bone erosion
Bone resorption
Nodular Fasciitis
Soft tissue neoplasms
Kurumlar
Selçuk Üniversitesi
Selçuklu Turkey
T. C. Sağlık Bakanlığı Ankara Diskapi Yildirim Beyazit Eğitim ve Araştirma Hastanesi
Ankara Turkey
The Pearl International Hospital
Doha Qatar
Turkish Hospital
Doha Qatar