Ultrasonography findings of intradermal nodular fasciitis: a rare case report and review of the literature

Extract

Conflict of interest: the authors declare that they have no conflicts of interest.

Introduction

Intradermal nodular fasciitis (INF) is a rare entity. We report a case of INF and report the findings from high‐resolution ultrasonography (US) imaging and histopathology.

A 37‐year‐old man presented in January 2006 with of a nodule on his arm. The nodule was pea‐sized, firm and rapidly growing, indicating malignancy in nature.

Grey‐scale ultrasonography (US) was performed, using a US machine (ProSound SSD‐3500; Aloka, Tokyo, Japan) equipped with a 10 MHz linear transducer attached to an echo coupler (MP‐2463), with a water bag serving as a fluid offset to diagnose the tumour and to determine its depth and extension before the operation. This procedure using a water bag is comparable to a high‐resolution imaging method, and all dermal layers from the superficial to the deeper layers were readily identified, as has been reported previously for evaluating skin invasion of breast cancer.1 The US revealed a circumscribed dermal nodule, 8.0 × 4.2 mm in size, which was projecting slightly into the subcutaneous fatty tissue. The lesion was relatively well‐demarcated with rough edges, in part projecting in a string‐like manner. The centre of the nodule showed a heterogeneous pattern of hypoechoic areas juxtaposed with hyperechoic streaks (Fig. 1a). Color Doppler US showed clear blood‐flow signals within the nodule (Fig. 1b).