Cranial fasciitis of childhood: a case report and review of literature.

Cranial fasciitis is a rare reactive, non-tumoral lesion (pseudosarcoma) that develops in childhood. It is a subset of nodular fasciitis that preferentially involves the scalps of children. This report presents a case of 24-month-old boy with a previous history of head trauma. A firm nodule, showing rapid growth over 1-month period, was seen at the occipital region. Computerized tomography showed the absence of erosion of the skull bones. The mass was completely excised with ample safety margin. Histologically, the growth was composed of mitotically active spindle-shaped cells embedded in a myxoid matrix. The lesional cells were immunoreactive for smooth muscle actin and the diagnosis of cranial fasciitis was established. No evidence of recurrence was seen 18 months after the diagnosis. This report describes the salient features of the case and discusses the relevant literature. It stresses the fact that cranial fasciitis is a rare lesion that must be included in the differential diagnosis of pediatric skull tumors. It also emphasizes that the correct diagnosis of these lesions is needed to avoid unnecessary surgery and radiotherapy.