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Case Report
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| Nodular fasciitis: A pseudomalignant clonal neoplasm characterized by USP gene rearrangements and spontaneous regression | ||||||
| Jennifer Hennebry1, Douglas Mulholland2, Nairi Tchrakian3, Charles Martin Gillham4, Peter Julian Beddy5, Dearbhaile Mai O'Donnell6, Máirín Eibhlín McMenamin7 | ||||||
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1MB BCh BAO, Senior House Officer, Internal Medicine, St. James's Hospital, Dublin, Ireland.
2MB BCh BAO, Specialist registrar in Radiology, Radiology department, St. James's Hospital, Dublin, Ireland. 3MB MCh BAO, Specialist registrar in Histopathology, Histopathology department, St. James's Hospital, Dublin, Ireland. 4FRCR, Consultant Radiation Oncologist, St. James's Hospital, Dublin, Ireland; 7MRCPI, Consultant Oncologist, St. James's Hospital, Dublin, Ireland. 5MB BCh BAO, Consultant Radiologist, Radiology department, St. James's Hospital, Dublin, Ireland. 6MRCPI, Consultant Oncologist, St. James's Hospital, Dublin, Ireland. 7FRCPath, Consultant Histopathologist Histopathology department, St. James's Hospital, Dublin, Ireland. | ||||||
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| How to cite this article |
| Hennebry J, Mulholland D, Beddy PJ, Tchrakian N, McMenamin ME, Gillham CM, O'Donnell DM. Nodular fasciitis: A pseudomalignant clonal neoplasm characterized by USP gene rearrangements and spontaneous regression. Int J Case Rep Images 2017;8(1):80–85. |
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Abstract
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Introduction:
Nodular fasciitis (NF) is a rapidly growing, self-limited, myofibroblastic neoplasm that typically arises in subcutaneous tissues of young adults and regresses spontaneously. Nodular fasciitis mimics sarcoma on clinical, radiological, and histological grounds and is usually, diagnosed following excision.
Case Report: A 26-year-old female presented at surveillance computed tomography (CT) scan one year post-treatment for stage 1c ovarian dysgerminoma with a 4 cm axillary soft tissue mass, radiologically suspicious for metastasis with subclavian vein invasion. Histopathology of core biopsies favored NF, confirmed by detection of USP6 gene rearrangements by FISH analysis. This case describes an unusual relatively deep NF, suspicious for metastasis on CT scan with confirmed spontaneous regression over two years. Conclusion: Nodular fasciitis should be considered in the differential diagnosis of rapidly growing enhancing soft tissue masses. Molecular cytogenetic testing of USP6 gene rearrangements allows definitive diagnosis on core biopsies in challenging cases, permitting a conservative approach and avoiding potentially radical and unnecessary surgery. | |
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Keywords:
Nodular fasciitis, Intravascular fasciitis, resolution, USP6, FISH
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Author Contributions
Jennifer Hennebry – Substantial contributions to conception and design, Acquisition of data, Drafting the article, Final approval of version to be published Douglas Mulholland – Acquisition of data, interpretation of data, Drafting the article, Final approval of version to be published Nairi Tchrakian – Substantial contributions to conception and design, Acquisition of data, Analysis and interpretation of data, Drafting the article, Revising it critically for important intellectual content, Final approval of the version to be published Charles Martin Gillham – Analysis and interpretation of data, Revising it critically for important intellectual content, Final approval of version to be published Peter Julian Beddy – Analysis and interpretation of data, Revising it critically for important intellectual content, Final approval of version to be published Dearbhaile Mai O'Donnell – Substantial contribution to conception and design, acquisition of data, Revising it critically for important intellectual content, Final approval of version to be published Máirín Eibhlín McMenamin – Substantial contribution to conception and design, acquisition of data, Revising it critically for important intellectual content, Final approval of version to be published |
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Guarantor of submission
The corresponding author is the guarantor of submission. |
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Source of support
None |
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Conflict of interest
Authors declare no conflict of interest. |
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Copyright
© 2017 Jennifer Hennebry et al. This article is distributed under the terms of Creative Commons Attribution License which permits unrestricted use, distribution and reproduction in any medium provided the original author(s) and original publisher are properly credited. Please see the copyright policy on the journal website for more information. |
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