{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,15]],"date-time":"2026-04-15T11:55:17Z","timestamp":1776254117594,"version":"3.50.1"},"reference-count":14,"publisher":"MDPI AG","issue":"2","license":[{"start":{"date-parts":[[2026,4,15]],"date-time":"2026-04-15T00:00:00Z","timestamp":1776211200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Reports"],"abstract":"<jats:p>Background and Clinical Significance: Nodular fasciitis is a benign, self-limited myofibroblastic proliferation that frequently mimics malignant soft-tissue tumors both clinically and radiologically. Although it has been well described in the extremities, its uncommon occurrence in the submandibular region poses a diagnostic challenge. Case Presentation: We report the case of a 22-year-old male patient, presenting with a rapidly enlarging painless swelling in the left submandibular region. Ultrasound demonstrated a well-defined subcutaneous lesion, while magnetic resonance imaging revealed heterogeneous enhancement with diffusion restriction, suggesting inflammatory or neoplastic pathology. Fine-needle aspiration cytology showed spindle-cell proliferation with pseudosarcomatous features, warranting histological examination to exclude malignancy. Surgical resection was performed. Histopathological examination demonstrated a myofibroblastic proliferation with tissue culture-like morphology. Immunohistochemistry showed diffuse SMA positivity while many other immunohistological markers were negative, arguing against several histologic mimics. Fluorescence in situ hybridization confirmed USP6 gene rearrangement, establishing the diagnosis of nodular fasciitis. Conclusions: This case highlights the diagnostic challenges posed by nodular fasciitis in the head and neck region and emphasizes the importance of correlating imaging, cytology, histopathology, and molecular findings to avoid overtreatment. The literature review further supports the benign clinical course of this rare entity in the submandibular region and underscores the value of including it in the differential diagnosis of submandibular masses.<\/jats:p>","DOI":"10.3390\/reports9020121","type":"journal-article","created":{"date-parts":[[2026,4,15]],"date-time":"2026-04-15T10:30:23Z","timestamp":1776249023000},"page":"121","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Submandibular Nodular Fasciitis Mimicking Inflammatory and Sarcomatous Lesions: A Case Report and Literature Review"],"prefix":"10.3390","volume":"9","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1332-0479","authenticated-orcid":false,"given":"Evangelos","family":"Kostares","sequence":"first","affiliation":[{"name":"Department of Oral and Maxillofacial Surgery, Dental School, National and Kapodistrian University of Athens, 115 27 Athens, Greece"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Georgia","family":"Kostare","sequence":"additional","affiliation":[{"name":"Department of Microbiology, Medical School, National and Kapodistrian University of Athens, 115 27 Athens, Greece"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Panagiota","family":"Vlachou","sequence":"additional","affiliation":[{"name":"Department of Pathology, Evangelismos General Hospital, Ipsilantou 45-47, 106 76 Athens, Greece"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4215-0798","authenticated-orcid":false,"given":"Kamil","family":"Nelke","sequence":"additional","affiliation":[{"name":"Maxillo-Facial Surgery Ward, EuroMediCare\u00a0 Hospital, Pilczycka 144, 54-144 Wroc\u0142aw, Poland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Theodore","family":"Argyrakos","sequence":"additional","affiliation":[{"name":"Department of Pathology, Evangelismos General Hospital, Ipsilantou 45-47, 106 76 Athens, Greece"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8791-2659","authenticated-orcid":false,"given":"Ourania","family":"Schoinohoriti","sequence":"additional","affiliation":[{"name":"Department of Oral and Maxillofacial Surgery, Dental School, National and Kapodistrian University of Athens, 115 27 Athens, Greece"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4140-0521","authenticated-orcid":false,"given":"Christos","family":"Perisanidis","sequence":"additional","affiliation":[{"name":"Department of Oral and Maxillofacial Surgery, Dental School, National and Kapodistrian University of Athens, 115 27 Athens, Greece"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Stavroula","family":"Diamantopoulou","sequence":"additional","affiliation":[{"name":"Department of Oral and Maxillofacial Surgery, Dental School, National and Kapodistrian University of Athens, 115 27 Athens, Greece"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2026,4,15]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"2192","DOI":"10.1038\/s41379-021-00883-x","article-title":"Nodular fasciitis: A comprehensive, time-correlated investigation of 17 cases","volume":"34","author":"Lippai","year":"2021","journal-title":"Mod. Pathol."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"805","DOI":"10.1002\/dc.20914","article-title":"Nodular fasciitis in the submandibular gland","volume":"36","author":"Jang","year":"2008","journal-title":"Diagn. Cytopathol."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"180","DOI":"10.1016\/j.anndiagpath.2015.03.013","article-title":"Nodular fasciitis: A retrospective study of 272 cases from China with clinicopathologic and radiologic correlation","volume":"19","author":"Lu","year":"2015","journal-title":"Ann. Diagn. Pathol."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"61","DOI":"10.1007\/s00238-016-1238-y","article-title":"Nodular fasciitis of the head and neck: Case report and review of literature","volume":"40","author":"Xu","year":"2017","journal-title":"Eur. J. Plast. Surg."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"S219","DOI":"10.5021\/ad.21.104","article-title":"Low-Grade Myofibroblastic Sarcoma on Back with Repeated Localized Recurrence and Regional Metastasis","volume":"35","author":"Park","year":"2023","journal-title":"Ann. Dermatol."},{"key":"ref_6","first-page":"850","article-title":"Clinicopathological characteristics and favourable prognosis of paediatric cutaneous nodular fasciitis: A case series","volume":"50","author":"Zhao","year":"2024","journal-title":"Clin. Exp. Dermatol."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"550","DOI":"10.1111\/ors.12674","article-title":"Nodular fasciitis in cervicofacial region: A rare case description and literature review","volume":"15","author":"Abbate","year":"2022","journal-title":"Oral Surg."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"e245584","DOI":"10.1136\/bcr-2021-245584","article-title":"Nodular fasciitis of the submandibular gland","volume":"15","author":"Wong","year":"2022","journal-title":"BMJ Case Rep."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"339","DOI":"10.1177\/01455613221118889","article-title":"Submandibular Nodular Fasciitis","volume":"104","author":"Davis","year":"2022","journal-title":"Ear Nose Throat J."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"335","DOI":"10.1177\/10668969251368868","article-title":"Head and Neck Region Nodular Fasciitis: A Clinicopathological Study of 50 Patients","volume":"34","author":"Fatima","year":"2025","journal-title":"Int. J. Surg. Pathol."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"bcr-2017-220611","DOI":"10.1136\/bcr-2017-220611","article-title":"Nodular fasciitis of soft tissue over the mandible","volume":"2017","author":"Yeomans","year":"2017","journal-title":"BMJ Case Rep."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"501","DOI":"10.1016\/j.ijscr.2012.05.018","article-title":"The chameleon in the neck: Nodular fasciitis mimicking malignant neck mass of unknown primary","volume":"3","author":"Borumandi","year":"2012","journal-title":"Int. J. Surg. Case Rep."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"924","DOI":"10.1016\/j.ijom.2006.06.006","article-title":"Nodular fasciitis in the orofacial region","volume":"35","author":"Han","year":"2006","journal-title":"Int. J. Oral Maxillofac. Surg."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"1211","DOI":"10.1053\/joms.2002.35037","article-title":"Maxillofacial nodular fasciitis: A report of 3 cases","volume":"60","author":"Alba","year":"2002","journal-title":"J. Oral Maxillofac. 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