Nodular fasciitis presenting as a rapidly enlarging episcleral mass in a 3-year-old.

A rapidly enlarging periocular mass in a child obligates the treating physician to rule out a malignancy, especially a rhabdomyosarcoma. A 3-year-old girl presented with a 5-day history of a rapidly growing episcleral mass superonasal to the globe, adjacent to the superior rectus muscle insertion. The lesion was locally excised. A sarcoma could not be excluded on frozen sections. Permanent sections and electron microscopy revealed nodular fasciitis, a benign lesion with a pseudosarcomatous histologic appearance. No recurrence has been noted at 9 months follow-up. Nodular fasciitis is a benign proliferation which should be considered in the differential diagnosis of a rapidly enlarging subconjunctival or orbital mass in a child.