Koosha Mohsen, Mostafavi Roya, Kheradmand Azin, Behjati Jina
Department of Neurosurgery, Imam Hossein Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Department of Pathology, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Int J Surg Case Rep. 2025 Aug;133:111695. doi: 10.1016/j.ijscr.2025.111695. Epub 2025 Jul 16.
Cranial fasciitis (CF) is a rare, benign fibroproliferative lesion primarily affecting children. Post-radiation CF is particularly uncommon, and has been reported in only seven previous cases. Its presentation often mimics malignancy, with nonspecific preoperative findings complicating the diagnosis, therefore necessitating early intervention.
We report a 12-year-old male with a history of medulloblastoma treated with chemoradiotherapy four years ago, who presented with a progressive right temporo-occipital scalp mass. Imaging showed an extradural mass with calvarial bone erosion. Complete surgical excision was performed, and histopathology confirmed CF. No recurrence was observed at six-month follow-up.
Post-radiation CF is an extremely rare complication of radiotherapy. Due to its rapid growth, bony invasion, and occasional intracranial extension, it can be misdiagnosed as a radiation-induced neoplasm. Given the overlap in clinical and radiologic features with malignancies such as meningioma or sarcoma, histopathological confirmation is essential. Unlike neoplasms, CF follows a benign course, and complete surgical excision is often curative.
Post-radiation CF should be considered in children with prior radiotherapy presenting with scalp masses. Early diagnosis and surgical intervention are crucial for avoiding unnecessary treatments and ensuring favorable outcomes.
颅骨筋膜炎（CF）是一种罕见的良性纤维增生性病变，主要影响儿童。放疗后发生的CF尤为罕见，此前仅有7例报道。其表现常类似恶性肿瘤，术前检查结果不具特异性，使诊断复杂化，因此需要早期干预。
我们报告一名12岁男性，4年前因髓母细胞瘤接受放化疗，现出现进行性右侧颞枕部头皮肿块。影像学检查显示硬膜外肿块伴颅骨侵蚀。进行了完整的手术切除，组织病理学确诊为CF。六个月随访未观察到复发。
放疗后CF是放疗极为罕见的并发症。因其生长迅速、侵犯骨质且偶有颅内扩展，可被误诊为放疗诱发的肿瘤。鉴于其临床和影像学特征与脑膜瘤或肉瘤等恶性肿瘤有重叠，组织病理学确诊至关重要。与肿瘤不同，CF病程呈良性，完整手术切除通常可治愈。
对于曾接受放疗且出现头皮肿块的儿童，应考虑放疗后CF。早期诊断和手术干预对于避免不必要的治疗及确保良好预后至关重要。
