A Novel Therapeutic Approach for Cranial Fasciitis Utilizing Frameless Stereotaxy

Abstract

Cranial fasciitis is a rare cause of a painless, progressive skull mass in the pediatric population, having been described in only 80 cases in the literature to-date. While the etiology remains unknown, the pathogenesis is thought to be a reactive process causing a non-neoplastic fibroblastic proliferation arising from the deep fascia or periosteum of the cranium. Accurate diagnosis may be delayed due to the lack of physical signs and symptoms on presentation, as well as equivocal imaging for the other lesions included in the differential diagnosis. Importantly, in the case of cranial fasciitis, involved tissue is hard to decipher from normal tissue in the cranium, and margin recommendations have not yet been made clear in the current literature. Herein, we present a case of confirmed cranial fasciitis in a 2-year-old female patient in whom frameless stereotaxy was used intraoperatively to determine the extent of the lesion and ensure adequate resection and minimize recurrence risk.