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Cranial fasciitis of childhood
D B Coates1, P Faught, A M Sadove
1Department of Oral and Maxillofacial Surgery, Indiana University Medical Center, Indianapolis.
Abstract:
Cranial fasciitis of childhood is a benign lesion occurring superficial to or involving the cranial bones of children at a median age of 18 months, with a male sex predilection of 2:1. It is histologically described as a well-circumscribed, loose proliferation of stellate to spindle-shaped fibroblasts in a myxoid background with foci of hemorrhage and hyalinization. Mitotic figures, increased cellularity, and cellular immaturity may be seen. The treatment of choice is excisional biopsy, since the lesion is not known to recur. It is important that the pathologist and surgeon alike be able to differentiate this benign condition from other lesions because of the clinically threatening presentation of cranial fasciitis.
Insights
Cranial fasciitis in children is a benign scalp lesion affecting infants, characterized by specific fibroblast proliferation. Complete surgical removal is curative, preventing recurrence and misdiagnosis of more serious conditions.
Area of Science:
- Pediatric Pathology
- Surgical Oncology
- Dermatopathology
Background:
- Cranial fasciitis is a rare, benign lesion affecting the scalp and cranial bones in young children.
- It presents superficially or involves the cranial bones, typically in males around 18 months of age.
Observation:
- Histologically, it shows a loose proliferation of fibroblasts in a myxoid stroma.
- Features include hemorrhage, hyalinization, increased cellularity, and occasional mitotic figures.
Findings:
- The lesion is well-circumscribed and benign, with no known recurrence after complete excision.
- Accurate differentiation from malignant neoplasms is crucial due to its potentially alarming clinical presentation.
Implications:
- Excisional biopsy is the recommended treatment for cranial fasciitis.
- Distinguishing this benign entity from aggressive tumors is vital for appropriate patient management and prognosis.