An unusual type of congenital subgaleal cyst, either dermoid or epidermoid, was found in 21 Nigerian infants. This entity was located in the midline of the scalp, anywhere from above the nasion to the inion, and occupied the subgaleal space. These cysts were noted soon after birth and gradually enlarged. They had no intracranial extension and were easily excised intact. Clinically, radiologically, and histologically they were similar to congenital inclusion dermoid cysts of the anterior fontanel. The histology and some of the peculiarities of these cysts are described. Although most of these cysts occur at the anterior fontanel, they can occur anywhere in the midline, and the subgaleal space of the anterior fontanel is not the exclusive site, as has been claimed by previous authors.
A parieto-occipital scalp tumor, noted in a Nigerian boy during the first month of his life, gradually increased in size, and after two attempts at partial removal there was a rapid increase in its size. When he was 17 years old, it measured 21 X 17 X 16 cm. There was no underlying skull defect. Complete excision of the tumor was achieved, and on histological examination it was found to be a fibrosarcoma. The patient was given a course of radiotherapy following wound healing. He remained well for 5 1/2 months but then had manifestations of small local recurrence and distant metastases that responded only minimally to another course of radiotherapy combined with cancer chemotherapy.
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