An approach to reconstructing a segmental defect of the mandible involving the condyle secondary to nodular fasciitis in a pediatric patient: a case report.

Abstract

Background: Nodular fasciitis is a rare, benign, and rapidly growing soft tissue lesion that predominantly affects the fascia and is typically observed in the extremities. However, its occurrence in the head and neck region is uncommon, making it a challenging entity to diagnose and treat. In the head and neck, the lesion can involve various structures including the soft tissue, muscles, and even the parotid gland. Clinically, patients may present with swelling, pain, or a rapidly enlarging mass often leading to misdiagnosis with more malignant conditions such as sarcomas or fibromatosis.

Case presentation: We present a case of a 12-year-old boy of Indian ethnicity with a progressively growing swelling over the face, which was initially thought to be a malignant tumor owing to its rapid growth. Biopsy confirmed the diagnosis of nodular fasciitis. Imaging revealed a large expansile lytic lesion involving the left hemimandible. The lesion was surgically excised and reconstruction and total joint replacement were done using patient-specific implants.

Conclusion: This report highlights the importance of considering nodular fasciitis in the differential diagnosis of rapidly growing soft tissue masses in the head and neck region. Prompt recognition and surgical intervention can lead to favorable results, restoring both function and esthetics for patients affected by this benign yet challenging condition.