Nodular fasciitis on the zygomatic region: immunohistochemical analysis and literature review
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Background: Nodular Fasciitis (NF) is characterized as a benign, fast-growing lesion with proliferation of fibroblasts and myofibroblasts. The use of immunohistochemistry is important for the diagnostic definition and if its findings are not clear, the differential diagnosis will be challenging, even more when the clinical findings do not correspond with the histopathological characteristics.
Objective: Here, we reported a case of dermal Nodular Fasciitis affecting zygomatic region of a 64 years old male who complained of swelling in the right side of the face for 3 months, which appeared after an ox-horn trauma.
Literature review: We reviewed the literature for all Nodular Fasciitis cases in the zygomatic region. Furthermore, we discussed the relationship of trauma as an etiological factor, main differential diagnoses and immunohistochemical markers for Nodular Fasciitis.
Case report: Incisional biopsy was done which revealed benign neoplasm of mesenchymal origin characterized by the fusocellular proliferation. Immunohistochemistry revealed positivity for VIM and SMA, being negative for S-100, CKs, CD34, and p53. The Ki-67 index was low. Due to the clinical, histopathological and immunohistochemical findings, the diagnosis of dermal NF was established.
Conclusion: This case consists of Nodular Fasciitis, which must be microscopically differentiated from dermatofibroma, solitary fibrous tumor, low-grade myofibroblastic sarcoma and atypical fibroxanthoma. Immunohistochemistry should always be performed to elucidate the nature of tumor cells and thus contribute to the correct diagnosis and treatment. Nodular Fasciitis appears to be uncommon in the zygomatic region.
Moisés Willian Aparecido Gonçalves, Universidade Federal dos Vales do Jequitinhonha e Mucuri
Universidade Federal dos Vales do Jequitinhonha e Mucuri, Faculdade de Ciências Biológicas e da Saúde, Departamento de Odontologia, Diamantina, Minas Gerais, Brasil.
Marina Rocha Fonseca Souza, Department of Dentistry
Universidade Federal dos Vales do Jequitinhonha e Mucuri, Faculdade de Ciências Biológicas e da Saúde, Departamento de Odontologia, Diamantina, Minas Gerais, Brasil.
Larissa Doalla de Almeida e Silva, Universidade Federal dos Vales do Jequitinhonha e Mucuri
Universidade Federal dos Vales do Jequitinhonha e Mucuri, Faculdade de Ciências Biológicas e da Saúde, Departamento de Odontologia, Diamantina, Minas Gerais, Brasil.
Cássio Roberto Rocha dos Santos, Universidade Federal dos Vales do Jequitinhonha e Mucuri
Universidade Federal dos Vales do Jequitinhonha e Mucuri, Faculdade de Ciências Biológicas e da Saúde, Departamento de Odontologia, Diamantina, Minas Gerais, Brasil.
João Luiz de Miranda, Universidade Federal dos Vales do Jequitinhonha e Mucuri
Universidade Federal dos Vales do Jequitinhonha e Mucuri, Faculdade de Ciências Biológicas e da Saúde, Departamento de Ciencias Basicas, Diamantina, Minas Gerais, Brasil.
Jorge Esquiche León, Universidade de São Paulo – USP
Universidade de São Paulo – USP, Ribeirão Preto Dental School, Department of Stomatology, Public Health and Forensic Dentistry, Ribeirão Preto, Brazil.
Ana Terezinha Marques Mesquita , Universidade Federal dos Vales do Jequitinhonha e Mucuri – UFVJM
Universidade Federal dos Vales do Jequitinhonha e Mucuri, Faculdade de Ciências Biológicas e da Saúde, Departamento de Odontologia, Diamantina, Minas Gerais, Brasil.
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Accepted 2022-05-12
Published 2022-02-07
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