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Cranial fasciitis.

J W Patterson1, S L Moran, H Konerding

  • 1Department of Pathology, Medical College of Virginia, Richmond.

Archives of Dermatology
|May 1, 1989
PubMed
Summary
This summary is machine-generated.

Cranial fasciitis, a rare scalp condition in children, presents as rapidly growing masses. Despite aggressive appearance, it is benign and curable with surgical excision, showing fibroblast and myofibroblast proliferation.

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Area of Science:

  • Pediatric Pathology
  • Surgical Oncology
  • Dermatopathology

Background:

  • Cranial fasciitis is a rare, rapidly growing scalp mass in children.
  • It shares similarities with nodular fasciitis but has a predilection for the pediatric scalp.
  • Understanding its nature is crucial for accurate diagnosis and treatment.

Observation:

  • Two pediatric cases (7-year-old boy, 3-year-old girl) with rapidly expanding scalp masses were analyzed.
  • Roentgenography revealed cranial erosion in one case.
  • Histopathological examination showed spindle cell proliferation, myxoid matrix, hemorrhage, and inflammation.

Findings:

  • Immunohistochemistry was largely negative for common markers but showed focal positivity for alpha 1-antichymotrypsin and smooth-muscle actin.

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  • Ultrastructural analysis identified myofibroblast features, including dilated endoplasmic reticulum and microfilaments.
  • Atypical nuclei were noted, but mitotic figures were uncommon, suggesting a benign process.

    • Implications:

    • Cranial fasciitis, despite rapid growth and occasional atypical cells, exhibits a benign clinical course.
    • Complete surgical excision is curative, with no recurrence observed in the reported cases.
    • The findings support cranial fasciitis as a proliferation of fibroblasts and myofibroblasts, similar to nodular fasciitis.