Lauer D H, Enzinger F M
Cancer. 1980 Jan 15;45(2):401-6. doi: 10.1002/1097-0142(19800115)45:2<401::aid-cncr2820450236>3.0.co;2-c.
Nine cases of fibroblastic lesions occurring in the cranium of young children were reviewed. The age of the patients at the time of initial treatment ranged from three weeks to six years (median 18 months), with the lesions being congenital in two cases. There was 2:1 male predominance. The size of the lesions averaged 2.5 cm in greatest dimension with the largest being 9.0 cm. All cases presented as rapidly growing masses with a preoperative duration of only two months. The lesions presented as soft-tissue masses deep in the scalp with involvement of the underlying cranium in all eight of the cases in which roentgenograms or operative reports were available for review. Characteristically, there was erosion of only the outer table of the skull, although in three cases the lesion extended through the inner table to attach to the underlying dura mater. It was not possible to detect the exact site or origin, although origin from one of the deep fascial layers of the scalp or the underlying periosteum seems most likely. Microscopically, the lesion appeared to be a proliferation of loosely arranged fibroblasts which most closely resembled nodular fasciitis. Mitotic figures as well as foci of osseous metaplasia were present. Treatment consisted of excision of the mass with local resection or curettage of the affected underlying bone in some cases. Followup revealed a benign clinical course with no recurrent or aggressive behavior.
回顾了9例发生于幼儿颅骨的纤维母细胞性病变。初次治疗时患者年龄为3周龄至6岁（中位年龄18个月），其中2例病变为先天性。男性占比为2:1。病变最大径平均为2.5 cm，最大者为9.0 cm。所有病例均表现为迅速生长的肿块，术前病程仅2个月。在有X线片或手术报告可供回顾的8例病例中，病变均表现为头皮深部的软组织肿块，并累及下方颅骨。其特征是仅颅骨外板受侵蚀，不过有3例病变延伸穿过内板并附着于下方硬脑膜。虽然病变似乎最有可能起源于头皮深层筋膜层或下方骨膜，但无法确定确切部位或起源。显微镜下，病变表现为疏松排列的纤维母细胞增生，最类似于结节性筋膜炎。可见核分裂象以及骨化生灶。治疗包括切除肿块，部分病例对受累下方骨质行局部切除或刮除。随访显示临床过程良性，无复发或侵袭性行为。
