Nodular fasciitis of the vulva: a study of six cases and literature review

Abstract

We report six cases of histologically typical nodular fasciitis that each presented as a vulvar soft tissue mass. The diagnosis of nodular fasciitis had not been considered by the referring pathologist in any of the five consultation cases. The patient's ages ranged from 7 to 51 years (mean 34). The lesion was confined to the labia in the four cases in which a specific site was noted. The masses ranged from 1.5 to 3.5 cm (mean 2.2) in maximal dimension. All of them were locally excised, and the resection margins were involved in each case. In addition to the typical features of nodular fasciitis, a noteworthy finding in two of the six cases was the presence of cleftlike spaces lined by plump synovial-like cells. Follow-up ranged from 3 months to 7 years (mean 24 months). A local recurrence developed in one patient at 4 months and was reexcised; there have been no recurrences in any other case. The literature contains only five additional examples of vulvar nodular fasciitis. Although all were pathologically typical, the diagnosis was often not considered, evidently because of the unusual location. Awareness that nodular fasciitis may occur in the vulva and the features that allow its distinction from other mesenchymal "tumors" occurring at this site will facilitate its correct diagnosis.