Post-radiation cranial fasciitis in a pediatric medulloblastoma survivor: A case report and systematic review.

Abstract

<h4>Introduction and importance</h4>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.<h4>Case presentation</h4>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.<h4>Clinical discussion</h4>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.<h4>Conclusion</h4>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.