Intravascular fasciitis

Abstract

Cases (17) of intravascular fasciitis are reported. It is characterized by the histologic features of nodular fasciitis but with intraluminal, intramural and extramural involvement of small to medium-sized veins and arteries and multinodular or serpentine growth along the course of affected blood vessels. A painless, slowly growing mass was most common. Fourteen patients (82%) were under age 30 (range 1/2-57 yr); the sex ratio was about equal. Seven cases were located on the upper extremity (3 hand, 2 wrist or forearm, 2 shoulder), 3 on the ankle or lower leg, 5 on the head and neck and 2 in the chest wall and breast. Most cases were small with a mean diameter of 1.5 cm, but two were elongated masses measuring 4-5 cm in length. At surgery, 4 cases showed intimate association with large veins or arteries. This type of fasciitis is rare and was found in only 1 of 14 consecutive cases of nodular fasciitis. Six of 15 consultation cases were misdiagnosed as sarcoma. Intravascular fasciitis is benign. Seven patients were free of disease from 2.5-20 yr (mean 9.5 yr); 5 patients had local recurrences.