What are the other Names for this Condition? (Also known as/Synonyms)

• Nodular Pseudosarcomatous Fasciitis of Salivary Gland
• Parotid Gland Nodular Fasciitis
• Salivary Gland Nodular Fasciitis

What is Nodular Fasciitis of Salivary Gland? (Definition/Background Information)

• Nodular Fasciitis of Salivary Gland is an extremely uncommon tumor, chiefly affecting the parotid gland (major salivary gland). It may be observed in both children and adults
• In general, nodular fasciitis is a benign, rapidly-growing mass that frequently affects the hands. This benign tumor reduces in size after a certain period of rapid growth (usually lasting 6 weeks), during which time it can cause severe anxiety to both the healthcare seeker and provider
• The diagnosis of Nodular Fasciitis of Salivary Gland may be challenging; however, a tissue biopsy can ensure a definitive diagnosis of the tumor
• A complete surgical removal of Nodular Fasciitis of Salivary Gland results in a cure and is the treatment of choice. However, since a spontaneous regression is noted in many cases, the physician may consider a ‘wait and watch’ approach too
• The prognosis of Nodular Fasciitis of Salivary Gland is excellent on suitable treatment. But, recurrence of the tumor has been observed in some rare cases

Who gets Nodular Fasciitis of Salivary Gland? (Age and Sex Distribution)

• Nodular Fasciitis of Salivary Gland is a highly infrequent tumor
• It may affect individuals in the age range of 10-70 years; average age of 45 years
• The tumor is observed in individuals of all races, ethnic groups, and both male and female gender

Currently, only a few cases of Salivary Gland Nodular Fasciitis have been reported worldwide. Since the tumor is uncommon, there is only limited information available in the medical literature.

What are the Risk Factors for Nodular Fasciitis of Salivary Gland? (Predisposing Factors)

• The risk factors for Nodular Fasciitis of Salivary Gland are currently unknown
• Trauma or injury to the region is not known to be a risk factor

It is important to note that having a risk factor does not mean that one will get the condition. A risk factor increases ones chances of getting a condition compared to an individual without the risk factors. Some risk factors are more important than others.

Also, not having a risk factor does not mean that an individual will not get the condition. It is always important to discuss the effect of risk factors with your healthcare provider.

What are the Causes of Nodular Fasciitis of Salivary Gland? (Etiology)

• Nodular Fasciitis of Salivary Gland is a benign tumor. It was considered to be a reactive process. However, some researchers believe that the tumor may actually be a neoplastic process
• The tumor rapidly grows over 3-6 weeks, after which it shrinks in size by itself, over a period of time (usually by the 16th week)
• Since, the tumor occurs as a rapidly-proliferating mass, it can be extremely worrisome and mistaken for a cancer growth, such as a sarcoma

What are the Signs and Symptoms of Nodular Fasciitis of Salivary Gland?

The signs and symptoms of Nodular Fasciitis of Salivary Gland include:

• Presence of a rapidly growing tumor mass by the side of the face; frequently, involvement of the parotid gland is noted
• The rapid growth may raise a suspicion of a malignancy and cause severe emotional stress
• Pain, feeling of tenderness
• The tumor is usually less than 5cm in size, even after a full growth

How is Nodular Fasciitis of Salivary Gland Diagnosed?

The diagnosis of Nodular Fasciitis of Salivary Gland may involve:

• Physical examination and evaluation of medical history
• Plain X-ray of the head and neck region
• Ultrasound scan of the affected salivary gland
• CT or CAT scan with contrast of the head and neck may show a well-defined mass. This radiological procedure creates detailed 3-dimensional images of structures inside the scanned region
• MRI scans of head and neck region: A magnetic field is used to create high-quality pictures of certain parts of the body, such as tissues, muscles, nerves, and bones. These high-quality pictures may reveal the presence of the tumor

Although the above modalities can be used to make an initial diagnosis, a tissue biopsy of the tumor is necessary to make a definitive diagnosis to begin treatment. The tissue for diagnosis can be procured in multiple different ways which include: 

• Fine needle aspiration (FNA) biopsy of the tumor: A FNA biopsy may not be helpful, because one may not be able to visualize the different morphological areas of the tumor. Hence, a FNA biopsy as a diagnostic tool has certain limitations, and an open surgical biopsy may be recommended.  
• Salivary gland core biopsy of the tumor
• Salivary gland open biopsy of the tumor

Tissue biopsy:

• A tissue biopsy of the tumor is performed and sent to a laboratory for a pathological examination. A pathologist examines the biopsy under a microscope. After putting together clinical findings, special studies on tissues (if needed) and with microscope findings, the pathologist arrives at a definitive diagnosis. Examination of the biopsy under a microscope by a pathologist is considered to be gold standard in arriving at a conclusive diagnosis
• Biopsy specimens are studied initially using Hematoxylin and Eosin staining. The pathologist then decides on additional studies depending on the clinical situation
• Sometimes, the pathologist may perform special studies, which may include immunohistochemical stains, molecular testing, and very rarely, electron microscopic studies to assist in the diagnosis

Note: A differential diagnosis to eliminate the presence of any malignancy (sarcoma) may be undertaken.

Many clinical conditions may have similar signs and symptoms. Your healthcare provider may perform additional tests to rule out other clinical conditions to arrive at a definitive diagnosis.

What are the possible Complications of Nodular Fasciitis of Salivary Gland?

The possible complications from Nodular Fasciitis of Salivary Gland may include:

• Discomfort while speaking, eating, etc.
• Surgery to remove the tumor mass may result in facial nerve palsy (surgical complication)
• Post-surgical wound infection
• Rarely, the tumor can recur on surgical removal
• Sudden tumor growth and size may affect the quality of one’s life

How is Nodular Fasciitis of Salivary Gland Treated?

• The treatment of Nodular Fasciitis of Salivary Gland is a complete surgical excision, which results in a cure
• Tumors that have sufficiently regressed may be treated conservatively
• Post-operative care is important: One must maintain minimum activity levels, until the surgical wound heals
• Follow-up following surgery/treatment is recommended

How can Nodular Fasciitis of Salivary Gland be Prevented?

• The cause of Nodular Fasciitis of Salivary Gland is unknown; hence, there are no known methods to prevent tumor occurrence
• Early diagnosis with close monitoring and treatment of the tumor is important

What is the Prognosis of Nodular Fasciitis of Salivary Gland? (Outcomes/Resolutions)

• The prognosis of Nodular Fasciitis of Salivary Gland is generally excellent, after surgical removal of the benign mass
• In many cases, these tumors are self-limiting and they shrink in size after 3-4 months

Additional and Relevant Useful Information for Nodular Fasciitis of Salivary Gland:

There are 3 major types of salivary glands and these include the following:

• Parotid glands, found on the sides of the face
• Submandibular glands located at the back of mouth, on both sides of the jaw
• Sublingual glands that are seen under the floor of the mouth

The salivary glands produce saliva that helps in:

• Lubricating the mouth
• Swallowing
• Protects the teeth against bacteria
• Digestion of food