Left maxillary nodular fasciitis: Case report

Nodular fasciitis is a rare, benign, discrete proliferation of reactive mesenchymal fibroblast arising from the superficial or deep facia or bony periosteum. Nodular fasciitis lesion is usually misdiagnosed as a sarcoma, due to its histological characteristics and its aggressive behavior. These lesions are rarely seen in pediatrics with a prevalence of less than 10 % of all reported cases. A 5-year-old girl who had no previous medical conditions. She came with a one-month history of swelling on the hard palate, which started suddenly and rapidly increased over time. According to the mother, she had been seeking treatment at another hospital where she was prescribed antibiotics, without improvement. Two weeks ago, she began experiencing swelling on the left side of her face, with her left eye being pushed upward. However, there was no decrease in vision, or double vision. A contrast-enhanced computed tomography scan of the paranasal sinuses was performed, revealing a mass in the left axilla and maxillary sinus. The mass, measuring approximately 4.1 x 4.2 × 3.6 cm, had a heterogeneous hypodense appearance and was exerting pressure on the left nasal cavity and nasal septum. To address the issue, the patient underwent successful endoscopic sinus surgery to remove a portion of the mass. The excised mass was then sent to the histopathology lab, where it was identified as a characteristic nodular fasciitis located in the left maxillary sinus. An endoscopic sinus surgery approach might be sufficient, with less pain and better post-op recovery in managing this type of lesion.