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Joseph Junewick, MD FACR
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Cranial Fasciitis

Case Detail

Anatomy: Neck-Face
Junewick
Joseph Junewick, MD FACR
Diagnostic Category: Neoplasia Benign
Created: over 5 years ago
Updated: over 5 years ago
Tags: PEDS
Modality/Study Types: CT MR
Activities:
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History

Toddler with an enlarging painless suboccipital soft tissue mass.


Case Images


Diagnosis

Cranial Fasciitis

Clinical Notes

History of left preauricular mass resected during infancy in a foreign country.

Findings

CT – Large left-sided soft tissue mass with transoccipital erosion.

MR – Mildly heterogeneous T1 hypointense and T2 and post-gadolinium hyperintense mass. No dural extension or reactive change.

Discussion

Cranial fasciitis is a rare benign rapidly growing fibroblastic tumor of the skull occurring in preschool aged children (median age of presentation of 21 months and males two time more frequently affected). Most lesions are single, arise from the deep fascia and erode into the skull (most often the temporoparietal region). The skull defect is usually geographic with sclerotic margins but can have an aggressive appearance. The mass is fairly homogeneous in density on CT but can have some calcification. On MR, signal is isointense to gray matter on T1 and T2 and shows enhancement. The dura is involved in nearly one-third of cases. Surgical excision is the definitive therapy; lesions tend to regress with time even with incomplete resection.

Reference

Keyserling HF, Castillo M, Smith JK. Cranial Fasciitis of Childhood. AJNR (2003); 24:1465-1467.



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