Proliferative fasciitis, a rare pseudosarcoma

Ajitha Porkodi Kv ,Thanka Johnson ,Rajendiran Swaminathan ,Susruthan Muralitharan ,Lawrence D Cruze

doi:10.18231/2394-6792.2018.0098

Abstract

Of the many benign mimickers of soft tissue sarcoma, proliferative fasciitis is a rare entity which is a diagnostic challenge for pathologist. Recognition of this pseudo sarcoma is very essential as it aids in the appropriate management of the same. Other members of the pseudo sarcoma family are proliferative myositis, nodular fasciitis, inflammatory pseudotumor and proliferative peribursitis. We present 3 cases of proliferative fasciitis which was reported in our hospital in the last 10 years, between 2007 and 2017. Keywords: Pseudosarcoma, Proliferative fasciitis, Rare soft tissue pseudo sarcoma.

Highlights

Proliferative fasciitis (PF) is a benign, reparative process that manifests as an acute onset-rapidly growing, tender mass, common site of occurence being in the upper and lower extremities especially in the forearm and thigh and rarely involving shoulders, chest and face
The most common conditions to be considered under the family of ‘Pseudo sarcomas’ apart from proliferative fasciitis, showing fibroblasts and myofibroblasts proliferations are proliferative myositis, nodular fasciitis, inflammatory pseudotumor and proliferative peribursitis
Nodular fasciitis is the most common condition mistaken for a sarcoma, which is a myofibroblastic proliferation characterised by extremely rapid growth (2 to 3 cm in weeks time)

Summary

Introduction

Proliferative fasciitis (PF) is a benign, reparative process that manifests as an acute onset-rapidly growing, tender mass, common site of occurence being in the upper and lower extremities especially in the forearm and thigh and rarely involving shoulders, chest and face. Due to its rapidly progressive nature, clinically it raises the suspicion of sarcoma. It is commonly seen in middle age and older adults between [40-70] years (mean age being 54 years). Patients present with acute onset, painful, palpable, firm, tender, subcutaneous nodule(s) which is freely mobile and unattached to the overlying skin. Immunohistochemistry on all cases showed positivity of the lesional cells to vimentin and SMA. All the three cases had in common the clinical suspicion of sarcomas due to the rapidly progressive, painful and tender nature of the swelling. In one of the cases, ultrasound showed well-defined heterogenous, hypoechoic lesion that raised the possibility of a soft tissue tumor.

Discussion

Conclusion