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Case Reports
. 2023 Nov;13(11):157-161.
doi: 10.13107/jocr.2023.v13.i11.4044.

Case Report: Rare Presentation of Nodular Fasciitis over Dorsum of Wrist

Ashootosh Batra  1 , Jaya Batra  2 , Tripti Pathare  3
Affiliations
Case Reports

Case Report: Rare Presentation of Nodular Fasciitis over Dorsum of Wrist

Ashootosh Batra et al. J Orthop Case Rep. 2023 Nov.

Abstract

Introduction: Nodular fasciitis is a benign, reactive fibroblastic tumor that usually presents as a rapidly growing lesion with occasional involvement of the deep fascia and muscle. We present a case of nodular fasciitis over the dorsum of the wrist. In our knowledge, this is the first reported case of nodular fasciitis at this location in the literature.

Case report: A 33-year-old South Asian male with a desk job, presented with a rapidly growing lesion over the dorsum of the left wrist over 5 months, associated with pain and restriction of dorsiflexion of wrist. The X-ray, ultrasound, and magnetic resonance imaging images were inconclusive and excisional biopsy was done for definitive diagnosis.

Conclusion: Nodular fasciitis is a relatively uncommon but important differential diagnosis for any rapid soft-tissue growth. It is a self-limiting proliferative fibroblastic lesion, with excisional biopsy as the gold standard for diagnosis of this condition.

Keywords: Nodular fasciitis; dorsum of wrist; excisional biopsy.

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Conflict of interest statement

Conflict of Interest: Nil

Figures

Figure 1
Figure 1
Solid hypoechoic lobulated mass on ultrasound .
Figure 2
Figure 2
X-ray suggestive of soft- tissue shadow (arrow).
Figure 3
Figure 3
Magnetic resonance imaging shows hypointense homogenous lesion in T1-weighted (a and c) and T2- weighted (b and d) images.
Figure 4
Figure 4
Hypointense T1- weighted image (a), with enhancement of T1 images post-contrast (b-d).
Figure 5
Figure 5
Intraoperative findings of non-cystic lesion (a), in close proximity to dorsal venous network (b).
Figure 6
Figure 6
Desmin negative staining.
Figure 7
Figure 7
CD 34 negative staining.
Figure 8
Figure 8
Interlacing and intersecting fascicles of bland smooth muscle cells.
Figure 9
Figure 9
Spindle-shaped fibroblasts (a), extravasated erythrocytes (b), and with loosely textured “ feathery” pattern of the mucopolysaccharide ground substance ( c).
Figure 10
Figure 10
Thick- walled blood vessels noted (arrow) with lack of mitosis.
See this image and copyright information in PMC

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