Nodular Fasciitis—A Rare Cause of a Rapidly Growing Ear Lesion in a 19-month-Old Child

Jordan N. Halsey, MD; Julien Hohenleitner, BS; Frank S. Ciminello, MD


ePlasty. 2020;20(ic13) 

In This Article

Case Description

A 9-month-old patient developed a small, skin-colored lesion in the conchal bowl of her left ear (Figure 1). There were no auditory abnormalities or pain associated with the lesion. The patient's dermatologist thought this mass to be a keloid and performed a steroid injection, with no treatment response. Ten months later, after minor trauma to the lesion during play at home, the lesion rapidly grew, ulcerated, and became prone to bleeding. Figure 2 shows the lesion prior to the trauma; Figure 3 shows the growth posttrauma. A biopsy was performed; the results were consistent with nodular fasciitis. The patient was referred to plastic surgery for evaluation. At the time, the lesion was 2.1 × 2.1 × 0.8 cm in size and invaded the entire conchal bowl, with near complete obstruction of the external auditory canal. An active clot with blood staining along the lobule and periauricular region was present.

Figure 1.

Left ear lesion at 9 months of age.

Figure 2.

Left ear lesion at 19 months of age, prior to the period of rapid proliferation.

Figure 3.

Left ear lesion in the child at 19 months of age, 3 days after mild trauma while playing at home.