CASE REPORT Nodular fasciitis of the head and neck: case report and review of literature Xinni Xu 1 & O-Wern Low 2 & Hui Wen Ng 3 & Jane Lim 2 & Thiam Chye Lim 2 & Wei Chen Ong 2 Received: 5 June 2016 /Accepted: 14 August 2016 /Published online: 27 August 2016 # Springer-Verlag Berlin Heidelberg 2016 Abstract Nodular fasciitis is a benign tumour arising from the proliferation of fibroblasts and myofibroblasts. A relative- ly rare occurrence in the head and neck, we present a case of nodular fasciitis located over the left zygoma of a patient. To expound on this, a review of literature was performed on cases of nodular fasciitis that have been previously reported. The objective of this study was to review the incidence, average demographic, characteristics and the outcome of management of patients with nodular fasciitis in the head and neck. We found a total of 46 cases of nodular fasciitis in the head and neck. The average size of the lesion was 2.16 cm. Majority of the head and neck nodular fasciitis (63.0 %) was located in the oral cavity, 28.3 % was on the facial region and the remaining 8.7 % was located on the neck. Of the 13 lesions present on the face, most of them were located over the midface (zygoma, parotid or cheek), with only three cases present on the mentum and none over the forehead. The incidence of associated trau- ma is 18.5 %. Nodular fasciitis in the head and neck region have been well documented in literature and should be con- sidered as a differential for lesions in the head and neck region. With proper work-up and approach, this benign condition can be managed appropriately with good overall prognosis and minimal morbidity. Level of Evidence: Level V, therapeutic study. Keywords Nodular fasciitis . Head and neck . Benign tumour . Differential diagnosis Introduction Nodular fasciitis is a benign tumour that arises from the pro- liferation of fibroblasts and myofibroblasts. It most commonly arises from the extremities and trunk and rarely from the head and neck region [1]. Despite its benign nature, it characteris- tically exhibits rapid growth, which is demonstrated on histol- ogy or cytology as increased mitotic activity. Therefore, often, a common differential diagnosis is that of a sarcoma, which has implications on the extent of surgical excision, especially when the lesion is located on the face. In view of this, we present a case report of nodular fasciitis to highlight the diagnostic dilemma when approaching lesions of its nature. Given that it is an uncommon lesion in the head and neck, a literature review of the cases of nodular fasciitis associated with the head and neck was performed to review the incidence, average demographic, characteristics and the outcome of management of patients with nodular fasciitis in the head and neck. We present the clinical and histological features of nodular fasciitis over the zygoma of a young gentleman. In addition, a systematic review of literature was performed using the PubMed search engine and the key words Bnodular fasciitis^. Six hundred articles were retrieved and further analysed for articles that included descriptions of nodular * Wei Chen Ong cfsowc@nus.edu.sg 1 Department of Otolaryngology—Head and Neck Surgery, National University Health System, National University Hospital, 5 Lower Kent Ridge Road, Singapore 119074, Singapore 2 Division of Plastic, Reconstructive and Aesthetic Surgery, Department of Surgery, National University Health System, National University Hospital, 5 Lower Kent Ridge Road, Singapore 119074, Singapore 3 Division of Plastic, Reconstructive and Aesthetic Surgery, Department of Surgery, Tan Tock Seng Hospital, 11 Jalan Tan Tock Seng, Singapore 308433, Singapore Eur J Plast Surg (2017) 40:61–66 DOI 10.1007/s00238-016-1238-y