Cranial fasciitis of childhood

Abstract

We present a child with a rapidly growing mass and lytic skull lesion that on pathologic evaluation was diagnosed as cranial fasciitis. This disease entity is not widely known by radiologists, and should be included in the differential diagnosis of lytic skull lesions.

Cranial fasciitis in an adult: CT and MR imaging findings

“…Although rare, the diagnosis is suggested when a rapidly growing mass is found in the temporo-parietal location in childhood. Periosteal fibroma has never been described in adult life, but the pattern of our case is very similar to the cases reported in children [4,5]. A benign chondroid tumor with central punctiform mineralization was the most probable diagnosis given the radiological features.…”

Cranial Fasciitis Presenting with Intracranial Mass: A Case Report

“…In most cases [2, 4, 10, 13, 17, 18, 33, 36], MRI showed iso-intensity as well as gray matter on T 1 - and T 2 -weighted images. Others reported low intensity on T 1 -weighted images and high intensity on T 2 -weighted images [19], [28], slightly high intensity on T 1 -weighted images [12], [23] and iso-intensity on T 1 -weighted images and high intensity on T 2 -weighted images (our case). Remarkable enhancement was seen after administration of contrast media.…”

“…Lesions occurred at the site of previous head trauma in 10 cases (20%) including birth trauma such as forceps delivery in 1 patient, but whether head trauma is an etiological factor has not been determined. In 12 of the reported 21 patients, skull X-ray showed an osteolytic change with a sclerotic rim [3, 4, 6, 13, 14, 18, 19, 24, 28, 36] and sometimes with a bone defect [2, 23], but in 8 patients [11, 12, 15, 21, 22, 25, 30], including ours, normal findings and in 1 patient [26] an ossifying change. CT scan showed an erosion, sometimes with calcification.…”

“…Forty-nine cases have been reported in the literature[1,2,3,4,5,6,7,8,9,10,11,12,13,14,15,16,17,18,19,20,21,22,23,24,25,26,27,28,29,30,31,32,33,34,35,36] and table 1 summarizes 50 cases of cranial fasciitis, including our patient. The average patient age is less than 3 years and ranges from newborn to 47 years.…”

Cranial fasciitis in an infant

“…11 The other differential diagnoses include sarcoidosis, infection, surface metastases, traumatic lesions, cavernous hemangiomas, myositis ossificans, Ewing sarcoma, fibrous histiocytoma, myxoid liposarcoma, myxofibrosarcoma, neurofibroma, meningioma, primary bone tumors, juvenile fibrosarcoma, and inflammatory lesions. 11,12 Although there are no definite predisposing factors, up to 15% of patients have a history of local trauma. 11 There have also been reports maintaining that these lesions are related to birth trauma and prior craniotomy.…”