Presentation
Swelling in arm, with some pain and tenderness.
Patient Data
A large well encapsulated mass lesion is seen subcutaneously in upper arm, appearing hypointense on T1W and hyperintense on T2W images and fat-suppressed sequence. Correlative ultrasonography (not included here) ruled out any cystic lesion or abscess, and a relatively homogenous soft tissue lesion was seen, with fibrous septations in periphery (also seen on MRI images).
Case Discussion
This case is a pathologically proven case of nodular fasciitis (also termed sometimes nodular pseudosarcomatous fasciitis).
Although nodular fasciitis tends to be smaller than 4-5 cm size, this is an unusual case with large size of the lesion. Possibilities of nodular fasciitis and low-grade fibrosarcoma were kept. While doing surgery, surgeon took a wide incision, and lesion was excised in-toto. It is important to rule out cold abscess in such cases, as a cold abscess could be easily drained by a smaller incision.