Cranial fasciitis of childhood]

A rare case of cranial fasciitis in a 1-year-old boy arising in the temporoparietal bone has been described. In 1990, Lauer and Endinger first reported cranial fasciitis, which is a benign subcutaneous tumor of the head developing from the deep fascia or the cranial periosteum and showing a pathological finding characterized by proliferation of fibroblasts. They described this tumor as "cranial fasciitis of childhood" in view of a high incident in infants and child. Cranial fasciitis grows rapidly in the scalp without pain, but its mean size is 2.5-3cm. Cranial fasciitis is closely related a clinical course and pathological findings to nodular fasciitis, which is also a benign proliferative fibroblast tumor developing from the subcutaneous muscular layers of the trunk and extremities (especially, the forearms), which was reported by Konwaler in 1955. However, cranial fasciitis differs from nodular fasciitis in that it is associated with the skull bone and, in many cases, the tumor destroys the inner and outer table of the skull and adheres to the dura mater. Cranial fasciitis should be considered to be a variant of nodular fasciitis. Neurosurgeons should be aware of this entity in the differential diagnosis of a firm lesion of the scalp in children. A brief review of the literature disclosed only 17 cases in the world. This case report is the first one of cranial fasciitis in Japan.