Nodular Fasciitis May Mimic Sarcoma

Molecular testing may help avoid overtreatment when benign soft-tissue tumors present with atypical clinical or histologic features.

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Nodular fasciitis can mimic sarcoma, leading to potential misdiagnosis and unnecessary aggressive treatment for a generally benign condition.
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A retrospective review of 29 cases revealed that 19 had nonspecific presentations, complicating the diagnosis of nodular fasciitis.
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Molecular testing, including FISH and NGS, identified USP6 gene fusions in many cases, aiding in the differentiation from malignant tumors.
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Histopathologic findings were consistent with nodular fasciitis, but variability in features contributed to diagnostic uncertainty.
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The study emphasizes that negative FISH results should not exclude nodular fasciitis diagnosis when histologic findings are suggestive.

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