Pediatric nodular fasciitis of the orofacial region: A rare case report and literature review.

Introduction: Nodular fasciitis is a rare, benign, rapidly growing, self-limited myofibroblastic/fibroblastic pseudotumor that often mimics sarcomas, making its diagnosis particularly challenging. While it typically occurs in the subcutaneous tissues of the trunk and extremities, intraoral presentation is extremely uncommon.

Case presentation: We report a rare case of oral nodular fasciitis in a 10-year-old patient who presented with delayed eruption of the right lower premolars and a firm, rapidly enlarging, painless swelling in the corresponding region. An excisional biopsy was performed, followed by immunohistochemical analysis, which confirmed the diagnosis of nodular fasciitis.

Clinical discussion: Due to its clinical and histopathological resemblance to malignant lesions, nodular fasciitis can easily be misdiagnosed, potentially leading to overtreatment. Recognizing its key features is essential to avoid unnecessary and invasive procedures, especially in pediatric patients.

Conclusion: This case highlights the importance of considering nodular fasciitis in the differential diagnosis of rapidly growing soft tissue masses in the oral cavity, particularly in children.