Summers Lori E, Florez Luisa, Berberian Z John M, Bhattacharjee Meena, Walsh John W
Department of Neurological Surgery, University of Florida, Gainesville, Florida 32610, USA.
J Neurosurg. 2007 Jun;106(6):1080-5. doi: 10.3171/jns.2007.106.6.1080.
The authors report two cases of cranial fasciitis occurring at prior craniotomy sites. They review the presentation and pathological features associated with cranial fasciitis and describe two unusual cases and their treatment. The first case is that of a 16-year-old girl who underwent suboccipital craniectomy for resection of medulloblastoma and 14 months later was found to have a 4-cm nontender mass at the incision site, with evidence of skull erosion on neuroimaging. Resection of the mass revealed cranial fasciitis. The patient later developed two more lesions in the cranial region, as well as lesions on the chest wall and abdomen consistent with nodular fasciitis; all of the lesions were resected. The second case is that of a 61-year-old man who underwent suboccipital craniectomy for hypertensive hemorrhage and 2 years later was found to have an enlarging mass at the incision site, causing compression of the cerebellum. The mass was resected and found to be consistent with cranial fasciitis. Cranial fasciitis is a rare, benign lesion of the cranial region. It is histologically identical to nodular fasciitis, a self-limiting fibroblastic process of the superficial and deep fascia. Although most cases of cranial fasciitis are reported to occur spontaneously in the very young, the two cases reported here involved older patients and lesions that developed at prior craniotomy sites in a delayed fashion, a phenomenon not previously reported. Interestingly, one patient exhibited lesions in other areas as well.
作者报告了两例发生于既往开颅手术部位的颅骨筋膜炎病例。他们回顾了与颅骨筋膜炎相关的临床表现和病理特征，并描述了两例不寻常的病例及其治疗情况。第一例是一名16岁女孩，因髓母细胞瘤切除术接受了枕下颅骨切除术，14个月后在切口部位发现一个4厘米大小的无痛性肿块，神经影像学检查显示有颅骨侵蚀迹象。肿块切除后显示为颅骨筋膜炎。该患者后来在颅部又出现了两处病变，以及胸壁和腹部符合结节性筋膜炎的病变；所有病变均被切除。第二例是一名61岁男性，因高血压脑出血接受了枕下颅骨切除术，2年后在切口部位发现一个不断增大的肿块，压迫小脑。肿块切除后发现符合颅骨筋膜炎。颅骨筋膜炎是一种罕见的颅部良性病变。它在组织学上与结节性筋膜炎相同，是浅筋膜和深筋膜的一种自限性成纤维细胞过程。尽管大多数颅骨筋膜炎病例据报道在非常年幼的患者中自发发生，但这里报告的两例涉及年龄较大的患者，且病变在既往开颅手术部位延迟出现，这一现象此前未见报道。有趣的是，其中一名患者在其他部位也出现了病变。
