Nodular fasciitis of the external ear region: A clinicopathologic study of 50 cases

Lester D.R. Thompson, Julie C. Fanburg-Smith, Bruce M. Wenig

Research output: Contribution to journalArticle

46 Citations (Scopus)

Abstract

Nodular fasciitis (NF), uncommon in the auricular area, is a benign reactive myofibroblastic proliferation that may be mistaken for a neoplastic proliferation. Fifty cases of NF of the auricular region were identified in the files of the Otorhinolaryngic-Head and Neck Tumor Registry of the Armed Forces Institute of Pathology. The patients included 22 females and 28 males, aged 1 to 76 years (mean, 27.4 years). The patients usually presented clinically with a mass lesion (n = 49). Five patients recalled antecedent trauma. The lesions were dermal (n = 28) or subcutaneous (n = 11) in those cases where histologic determination was possible, measuring 1.9 cm on average. The majority of the lesions were circumscribed (n = 38), composed of spindle-shaped to stellate myofibroblasts arranged in a storiform growth pattern, juxtaposed to hypocellular myxoid tissue-culture-like areas with extravasation of erythrocytes. Dense, keloid-like collagen and occasional giant cells were seen (n = 18). Mitotic figures (without atypical forms) were readily identifiable. By immunohistochemical staining, myofibroblasts were reactive with vimentin, actins, and CD68. All patients had surgical excision. Four patients (9.3%) developed local recurrence and were alive and disease free at last follow-up. All patients with follow-up (n = 43) were alive or had died of unrelated causes, without evidence of disease an average 13.4 years after diagnosis. Nodular fasciitis of the auricular area occurs most often in young patients. Because NF is more often dermally situated than extremity NF, it may present with superficial ulceration and/or bleeding. Local recurrence is more frequent because of the difficulty in obtaining complete surgical excision around the ear.

Original languageEnglish (US)
Pages (from-to)191-198
Number of pages8
JournalAnnals of Diagnostic Pathology
Volume5
Issue number4
DOIs
StatePublished - Jan 1 2001

Fingerprint

Fasciitis
External Ear
Myofibroblasts
Keloid
Recurrence
Vimentin
Giant Cells
Ear
Registries
Actins
Neck
Collagen
Extremities
Erythrocytes
Head
Pathology
Staining and Labeling
Hemorrhage
Skin
Wounds and Injuries

All Science Journal Classification (ASJC) codes

  • Pathology and Forensic Medicine

Cite this

@article{c088c76a92c34b719a9d0a1feef7ed50,
title = "Nodular fasciitis of the external ear region: A clinicopathologic study of 50 cases",
abstract = "Nodular fasciitis (NF), uncommon in the auricular area, is a benign reactive myofibroblastic proliferation that may be mistaken for a neoplastic proliferation. Fifty cases of NF of the auricular region were identified in the files of the Otorhinolaryngic-Head and Neck Tumor Registry of the Armed Forces Institute of Pathology. The patients included 22 females and 28 males, aged 1 to 76 years (mean, 27.4 years). The patients usually presented clinically with a mass lesion (n = 49). Five patients recalled antecedent trauma. The lesions were dermal (n = 28) or subcutaneous (n = 11) in those cases where histologic determination was possible, measuring 1.9 cm on average. The majority of the lesions were circumscribed (n = 38), composed of spindle-shaped to stellate myofibroblasts arranged in a storiform growth pattern, juxtaposed to hypocellular myxoid tissue-culture-like areas with extravasation of erythrocytes. Dense, keloid-like collagen and occasional giant cells were seen (n = 18). Mitotic figures (without atypical forms) were readily identifiable. By immunohistochemical staining, myofibroblasts were reactive with vimentin, actins, and CD68. All patients had surgical excision. Four patients (9.3{\%}) developed local recurrence and were alive and disease free at last follow-up. All patients with follow-up (n = 43) were alive or had died of unrelated causes, without evidence of disease an average 13.4 years after diagnosis. Nodular fasciitis of the auricular area occurs most often in young patients. Because NF is more often dermally situated than extremity NF, it may present with superficial ulceration and/or bleeding. Local recurrence is more frequent because of the difficulty in obtaining complete surgical excision around the ear.",
author = "Thompson, {Lester D.R.} and Fanburg-Smith, {Julie C.} and Wenig, {Bruce M.}",
year = "2001",
month = "1",
day = "1",
doi = "10.1053/adpa.2001.26969",
language = "English (US)",
volume = "5",
pages = "191--198",
journal = "Annals of Diagnostic Pathology",
issn = "1092-9134",
publisher = "W.B. Saunders Ltd",
number = "4",

}

Nodular fasciitis of the external ear region : A clinicopathologic study of 50 cases. / Thompson, Lester D.R.; Fanburg-Smith, Julie C.; Wenig, Bruce M.

In: Annals of Diagnostic Pathology, Vol. 5, No. 4, 01.01.2001, p. 191-198.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Nodular fasciitis of the external ear region

T2 - A clinicopathologic study of 50 cases

AU - Thompson, Lester D.R.

AU - Fanburg-Smith, Julie C.

AU - Wenig, Bruce M.

PY - 2001/1/1

Y1 - 2001/1/1

N2 - Nodular fasciitis (NF), uncommon in the auricular area, is a benign reactive myofibroblastic proliferation that may be mistaken for a neoplastic proliferation. Fifty cases of NF of the auricular region were identified in the files of the Otorhinolaryngic-Head and Neck Tumor Registry of the Armed Forces Institute of Pathology. The patients included 22 females and 28 males, aged 1 to 76 years (mean, 27.4 years). The patients usually presented clinically with a mass lesion (n = 49). Five patients recalled antecedent trauma. The lesions were dermal (n = 28) or subcutaneous (n = 11) in those cases where histologic determination was possible, measuring 1.9 cm on average. The majority of the lesions were circumscribed (n = 38), composed of spindle-shaped to stellate myofibroblasts arranged in a storiform growth pattern, juxtaposed to hypocellular myxoid tissue-culture-like areas with extravasation of erythrocytes. Dense, keloid-like collagen and occasional giant cells were seen (n = 18). Mitotic figures (without atypical forms) were readily identifiable. By immunohistochemical staining, myofibroblasts were reactive with vimentin, actins, and CD68. All patients had surgical excision. Four patients (9.3%) developed local recurrence and were alive and disease free at last follow-up. All patients with follow-up (n = 43) were alive or had died of unrelated causes, without evidence of disease an average 13.4 years after diagnosis. Nodular fasciitis of the auricular area occurs most often in young patients. Because NF is more often dermally situated than extremity NF, it may present with superficial ulceration and/or bleeding. Local recurrence is more frequent because of the difficulty in obtaining complete surgical excision around the ear.

AB - Nodular fasciitis (NF), uncommon in the auricular area, is a benign reactive myofibroblastic proliferation that may be mistaken for a neoplastic proliferation. Fifty cases of NF of the auricular region were identified in the files of the Otorhinolaryngic-Head and Neck Tumor Registry of the Armed Forces Institute of Pathology. The patients included 22 females and 28 males, aged 1 to 76 years (mean, 27.4 years). The patients usually presented clinically with a mass lesion (n = 49). Five patients recalled antecedent trauma. The lesions were dermal (n = 28) or subcutaneous (n = 11) in those cases where histologic determination was possible, measuring 1.9 cm on average. The majority of the lesions were circumscribed (n = 38), composed of spindle-shaped to stellate myofibroblasts arranged in a storiform growth pattern, juxtaposed to hypocellular myxoid tissue-culture-like areas with extravasation of erythrocytes. Dense, keloid-like collagen and occasional giant cells were seen (n = 18). Mitotic figures (without atypical forms) were readily identifiable. By immunohistochemical staining, myofibroblasts were reactive with vimentin, actins, and CD68. All patients had surgical excision. Four patients (9.3%) developed local recurrence and were alive and disease free at last follow-up. All patients with follow-up (n = 43) were alive or had died of unrelated causes, without evidence of disease an average 13.4 years after diagnosis. Nodular fasciitis of the auricular area occurs most often in young patients. Because NF is more often dermally situated than extremity NF, it may present with superficial ulceration and/or bleeding. Local recurrence is more frequent because of the difficulty in obtaining complete surgical excision around the ear.

UR - http://www.scopus.com/inward/record.url?scp=0034858441&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0034858441&partnerID=8YFLogxK

U2 - 10.1053/adpa.2001.26969

DO - 10.1053/adpa.2001.26969

M3 - Article

C2 - 11510001

AN - SCOPUS:0034858441

VL - 5

SP - 191

EP - 198

JO - Annals of Diagnostic Pathology

JF - Annals of Diagnostic Pathology

SN - 1092-9134

IS - 4

ER -