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Parosteal fasciitis in children
1Division of Orthopaedics, University of Ottawa, Ontario, Canada.
Insights
Parosteal fasciitis, a benign fibrous lesion, can be mistaken for cancer. This study details four pediatric cases, finding it rare but presenting similar features to adult cases.
Area of Science:
- Orthopedic Pathology
- Pediatric Oncology
Background:
- Parosteal fasciitis is a benign fibrous lesion often misdiagnosed as malignancy.
- Understanding its presentation in children is crucial for accurate diagnosis and treatment.
Observation:
- Reviewed four pediatric cases (ages 9-15) of parosteal fasciitis.
- All lesions were located in the lower extremities.
- Histological analysis revealed fibroblastic proliferation, inflammation, capillary networks, and metaplastic bone.
Findings:
- Parosteal fasciitis is uncommon in children.
- Pediatric cases exhibit identical clinicopathological features to adult lesions.
- Local excision is the primary treatment, with a noted recurrence in one case.
Implications:
- Established clinicopathological criteria for diagnosing parosteal fasciitis in children.
- Highlights the importance of distinguishing this benign entity from malignant tumors in pediatric patients.
- Informs surgical management and follow-up strategies for pediatric parosteal fasciitis.
Abstract:
Parosteal fasciitis is a pseudosarcomatous benign lesion of fibrous tissue that has often been confused with malignancy. The purpose of this study was to document the clinical and pathological features of four children with this condition and compare the results with the world literature. The ages of the patients whose cases were reviewed ranged from 9 to 15 years. There were three girls and one boy. All the lesions occurred in the lower extremities, and histologically were characterized by a fibroblastic proliferation with inflammatory cells, diffuse capillary network, and varying quantities of metaplastic bone. All patients were treated by local excision of the lesion. One child had a recurrence of the lesion requiring another surgical removal. A set of clinicopathological criteria has been formulated for the diagnosis of parosteal fasciitis in children. Parosteal fasciitis is uncommon in children but manifests the same clinicopathological features as the adult lesion.