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Published on: September 18, 2019
[A case of cranial fasciitis induced by trauma]
Sumito Okuyama1, Takamasa Kayama, Yukihiko Sonoda
1Department of Neurosurgery, Yamagata University School of Medicine, 2-2-2 Iida-nishi, Yamagata 990-9585, Japan.
Insights
Cranial fasciitis, a benign tumor in children, may be linked to head trauma. This rare condition, often mistaken for sarcoma, is curable with surgery.
Area of Science:
- Pediatric Pathology
- Surgical Oncology
- Dermatopathology
Background:
- Cranial fasciitis is a rare, benign fibroblastic tumor typically affecting children.
- It shares pathological similarities with nodular fasciitis, a condition more common in adults.
Observation:
- A 20-month-old boy presented with a rapidly growing occipital mass following head trauma.
- Pathological diagnosis confirmed cranial fasciitis, a lesion often misdiagnosed as sarcoma due to rapid growth and cellularity.
Findings:
- Review of 40 global cases revealed that 20% had a history of preceding head trauma.
- This suggests a potential causal link between head trauma and the development of cranial fasciitis.
Implications:
- Cranial fasciitis is likely a variant of nodular fasciitis, distinct in its cranial location and pediatric occurrence.
- Understanding the role of head trauma may aid in diagnosis and prevention strategies for this benign tumor.
Abstract:
We present a 20-month-old boy with a rapid growing occipital mass after head trauma, that was pathologically diagnosed as cranial fasciitis. Cranial fasciitis, first described as a specific entity by Lauer and Enzinger in 1980, is a benign fibroblastic lesion occurring in children that resembles nodular fasciitis pathologically. Nodular fasciitis also shows benign proliferation of fibroblasts and myofibroblasts in the subcutaneous tissues. This disease was firstly reported in 1955. This lesion is arising in the upper and lower extremities and trunk in adult commonly. The rapid growth, abundant cellularity, and mitotic activity cause these lesions to be misdiagnosed as sarcomas frequently. However, these lesions recur rarely, do not develop metastases, and are readily cured only by surgical excision. Cranial fasciitis is similar to nodular fasciitis in clinical cause and pathology. Therefore cranial fasciitis should be considered a variant of nodular fasciitis, although it differs from noduler fasciitis in its frequent site and age. Cranial fasciitis occurs in skull bone and in childhood. The cause of them are still unknown. However, we speculate on the relationship between head trauma and cranial fasciitis making reference to the fact that 5-15% of nodular fasciitis were caused by trauma. So we investigated this relationship in cranial fasciitis, then 8 cases of 40 cases(20%), that we could trace in the world literatures, had histories of previous head trauma. From this result, head trauma is one of a cause of cranial fasciitis probably.
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