Pediatric Cranial Fasciitis: Discussion of Cases and Systematic Review of the Literature

Abstract

Objective: Cranial fasciitis is a rare benign mass that typically presents in pediatric patients from 3 weeks to 6 years of age. It is classified as a subset of nodular fasciitis and was first reported in 1980. This study evaluates the literature for common characteristics that may affect diagnosis and treamtent.

Methods: We describe the case of a 13-month-old girl with a history of accidental head trauma 7 months before presentation and the case of a 5-month-old girl with an expansile skull lesion. We also performed a systematic review of the reported data on cranial fasciitis, including a total of 57 reported studies with 80 unique cases.

Results: There were 80 total cases reviewed in the literature. There was a male predominence, 1.75:1. The average age at presentation was 5.2 years. The most common causes for this lesion were idiopathic (65%), blunt trauma (14%) and radiation therapy (7%). Overall, there was a 9% recurrence rate following treatment.

Conclusion: We report the characteristics at presentation, including, to the best of our knowledge, the first account of gender differences, and the treatment modalities used in the included studies and the implications in relation to the recurrence rates.

Keywords: Cranial fasciitis; Craniectomy; Cranioplasty; Nodular fasciitis; Pediatric trauma; Scalp mass; Skull mass.