The management of periorbital nodular fasciitis using intra-lesional triamcinolone: a case report and review of the literature

ABSTRACT

Nodular fasciitis (NF) is a subcutaneous, nodular, pseudo-sarcomatous, fibroblastic proliferation. It is rarely reported in the periorbital region and the management approach is variable.

Presented is an eight-year-old female with a three month history of a periorbital mass. Incisional biopsy histologically confirmed nodular fasciitis with a unique gene translocation. The lesion was treated primarily with one intra-lesional injection of triamcinolone acetonide. Four months post-injection, the lesion resolved completely. No recurrence was seen at 12-months follow-up post-injection. No side effects were noted.

To our knowledge. this is the first reported use of intra-lesional triamcinolone acetonide as a first-line treatment in periorbital NF. We found this to be a safe and effective treatment, which can obviate the need for surgical excision in a cosmetically sensitive region.

KEYWORDS:

• Nodular fasciitis
• periorbita
• triamcinolone
• orbital
• steroid
• pathology

Acknowledgments

We are grateful to Drs Olaf Ansorge (Oxford University Hospitals NHS Foundation Trust) and Anna Kelsey (Manchester University NHS Foundation Trust), who reviewed the biopsy, made the diagnosis and provided the images.

None of the authors have any conflict of interest related to any element discussed in the manuscript.