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<p>We present the case of a 10-year-old girl with no significant medical history who was evaluated for a progressively enlarging, painless swelling behind the right ear, persisting over four months. The clinical examination revealed a subtle obliteration of the retro-auricular sulcus without any overt mass or associated symptoms such as otalgia, otorrhea, or facial nerve dysfunction. Imaging via ultrasound and MRI identified a well-circumscribed, vascularized, retro-auricular soft tissue mass adjacent to but not invading the parotid gland or temporal bone. Surgical excision was performed under general anesthesia, revealing a friable, poorly demarcated mass adherent to the auricular cartilage. Histological analysis confirmed the diagnosis of nodular fasciitis with positive staining for smooth muscle actin and negative markers for S100 and CD34. This case highlights the diagnostic challenge posed by NF in uncommon locations in children and underscores the importance of considering this benign entity in the differential diagnosis of rapidly growing pediatric head and neck masses to avoid overtreatment.</p>

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Nodular Fasciitis Mimicking Malignancy in the Retroauricular Region of a Pediatric Patient

  • 期刊论文

  • 发表日期：

    2025年9月30日

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  • Monia Ghammam,
  • Jihène Houas,
  • Fatma Kanfoudi,
  • Islem Dakhli,
  • Sarra Yacoob,
  • Amira Attigue,
  • Wassim Kermani

摘要

We present the case of a 10-year-old girl with no significant medical history who was evaluated for a progressively enlarging, painless swelling behind the right ear, persisting over four months. The clinical examination revealed a subtle obliteration of the retro-auricular sulcus without any overt mass or associated symptoms such as otalgia, otorrhea, or facial nerve dysfunction. Imaging via ultrasound and MRI identified a well-circumscribed, vascularized, retro-auricular soft tissue mass adjacent to but not invading the parotid gland or temporal bone. Surgical excision was performed under general anesthesia, revealing a friable, poorly demarcated mass adherent to the auricular cartilage. Histological analysis confirmed the diagnosis of nodular fasciitis with positive staining for smooth muscle actin and negative markers for S100 and CD34. This case highlights the diagnostic challenge posed by NF in uncommon locations in children and underscores the importance of considering this benign entity in the differential diagnosis of rapidly growing pediatric head and neck masses to avoid overtreatment.