Nodular fasciitis in the orofacial region: a report of three cases.

Nodular fasciitis is a benign fibroblastic proliferate lesion that is thought to be a response of tissue to injury. It usually presents as a rapidly growing subcutaneous mass. Upper extremities are most commonly affected, followed by the head and neck region. The clinical behaviour and histological presentation mimic those of malignant tumours, thus the lesion is easily misdiagnosed. The authors report here three cases of orofacial nodular fasciitis and review the literature focused on the diagnosis of the disease. Patient one had a history of trauma. The physical examination, radiographic features and findings in surgery were suggestive of a malignant tumour. The final diagnosis of nodular fasciitis was made through the immunohistochemical pathology. The other two patients had no history of trauma, but presented typical clinical and pathological features of nodular fasciitis. It is essential that dentists are aware of the distinctions between nodular fasciitis and malignant tumours in order to limit overtreatment and treatment-related morbidity.