A systematic approach in the diagnosis of paediatric skull lesions: what radiologists need to know

Choudhary, Gagandeep; Udayasankar, Unni K.; Saade, Charbel; Winegar, Blair A.; Maroun, Gilbert; Chokr, Jad

doi:10.5114/pjr.2019.83101

Cited by 21 publications

(32 citation statements)

References 113 publications

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“…In patients with primary orbital and periorbital involvement, osteomyelitis, metastatic neuroblastoma, Ewing sarcoma, rhabdomyosarcoma, chloroma and lymphoma must be excluded. Among soft tissue sarcomas, rhabdomyosarcoma is the most common tumor in children and is most commonly observed in the head and neck region [ 12 ]. Osteosarcoma is the most common malignant primary bone tumor [ 12 ], but it is most commonly observed in the long bones, and craniofacial bones are rarely involved.…”

Section: Discussionmentioning

confidence: 99%

“…Among soft tissue sarcomas, rhabdomyosarcoma is the most common tumor in children and is most commonly observed in the head and neck region [ 12 ]. Osteosarcoma is the most common malignant primary bone tumor [ 12 ], but it is most commonly observed in the long bones, and craniofacial bones are rarely involved. Ewing sarcoma is the second most common malignant primary bone tumor in children, and it is common in both long and flat bones [ 12 ].…”

Section: Discussionmentioning

confidence: 99%

“…Osteosarcoma is the most common malignant primary bone tumor [ 12 ], but it is most commonly observed in the long bones, and craniofacial bones are rarely involved. Ewing sarcoma is the second most common malignant primary bone tumor in children, and it is common in both long and flat bones [ 12 ]. Metastatic neuroblastoma is characteristically involved in the posterolateral part of the orbit, frontal bone and greater wing of the sphenoid bone [ 13 ].…”

Section: Discussionmentioning

confidence: 99%

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Diagnostic Challenge in Rapidly Growing Langerhans Cell Histiocytosis with Aneurysmal Bone Cyst in the Maxilla: A Case Report

et al. 2022

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Langerhans cell histiocytosis (LCH) is a rare neoplastic disorder characterized by the clonal proliferation of CD1a +/CD 207 + dendritic cells, whose features are similar to those of epidermal Langerhans cells. LCH is more common in children than in adults. Localized osteolytic lesions in the craniofacial bones are the most common manifestations of LCH. However, LCH can also present as a multifocal and multisystem disease with poor prognosis. Locally aggressive LCH needs to be differentiated from various diseases such as osteomyelitis, malignant bone tumors, and soft tissue sarcomas. However, it is difficult to diagnose, since the imaging findings are nonspecific. We report a case of a highly aggressive LCH in the maxilla accompanied by a fluid-fluid level.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Diagnostic Challenge in Rapidly Growing Langerhans Cell Histiocytosis with Aneurysmal Bone Cyst in the Maxilla: A Case Report

et al. 2022

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“…Cephalohematomas generally do not pose a significant risk to the patient and resolve spontaneously. [5][6][7] Conversely, a subgaleal hematoma is a rare but more serious condition. It describes bleeding in the potential space between the periosteum and the galea aponeurosis.…”

Section: Discussionmentioning

confidence: 99%

Point-of-care Ultrasound to Distinguish Subgaleal and Cephalohematoma: Case Report

Acuña

Adhikari

2021

Clinical Practice and Cases in Emergency Medicine

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Introduction: Cephalohematomas generally do not pose a significant risk to the patient and resolve spontaneously. Conversely, a subgaleal hematoma is a rare but more serious condition. While it may be challenging to make this diagnostic distinction based on a physical examination alone, the findings that differentiate these two conditions can be appreciated on point-of-care ultrasound (POCUS). We describe two pediatric patient cases where POCUS was used to distinguish between a subgaleal hematoma and a cephalohematoma. Case Reports: We describe one case of a 14-month-old male brought to the pediatric emergency department (PED) with concern for head injury. A POCUS examination revealed a large fluid collection that did not cross the sagittal suture. Thus, the hematoma was more consistent with a cephalohematoma and less compatible with a subgaleal hematoma. Given these findings, further emergent imaging was deferred in the PED and the patient was kept for observation. In the second case an 8-week-old male presented with suspected swelling over the right parietal region. A POCUS examination was performed, which demonstrated an extensive, simple fluid collection that extended across the suture line, making it more concerning for a subgaleal hematoma. Given the heightened suspicion for a subgaleal hematoma, the patient was admitted for further imaging and evaluation. Conclusion: Point-of-care ultrasound can be used to help differentiate between a subgaleal hematoma and a cephalohematoma to risk-stratify patients and determine the need for further imaging.

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“…Epidermoid tumors on the brain CT scan show fluid density, while dermoid cysts show fat density. (11,14) On magnetic resonance imaging, epidermoid cysts are circumscribed lesions and well demarcated. The cyst wall has low signal intensities on T1-or T2-weighted images.…”

Section: Discussionmentioning

confidence: 99%

Pediatric skull bone defect due to epidermoid cyst

Sinurat

Gultom

2021

Universa Medicina

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Background Tumors of the skull usually affect adult patients and less than twenty percent of pediatric patients. As the tumors grow, the surrounding bone may undergo destruction and erosion. When the tumors are located in the fontanel, the timely closure of the fontanel may be inhibited. Epidermoid cysts are benign tumors that are intracranially located and very rarely in the midline of the cranium. Meanwhile about 32% of stratified-squamous epithelial epidermoid cysts affect the head and neck region and only 6.7% occur in the scalp. We report an unusual epidermoid cyst located and growing in the anterior fontanel of a pediatric patient and inhibiting fontanel closure. Case Description A 21-month-old boy and his parents visited our polyclinic because there was a lump on his anterior fontanel since four months before they came to the hospital. The lump was initially the size of a peanut and had grown to become as large as a quail’s egg. The physical examination was normal and the brain CT-scan showed bone destruction without any intracranial lesion. The tumor was excised on the preoperative diagnosis of dermoid cyst. Histopathology examination showed the characteristics of an epidermoid cyst. The cyst had a wall and was full of keratin flakes without hair follicles or sebaceous glands. Follow-up one year after complete excision did not reveal any recurrence. Conclusion Epidermoid cysts in the skull of pediatric patients must be completely excised as soon as possible because their growth can damage the bone and inhibit the closure of the sutures.

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A systematic approach in the diagnosis of paediatric skull lesions: what radiologists need to know

Cited by 21 publications

References 113 publications

Diagnostic Challenge in Rapidly Growing Langerhans Cell Histiocytosis with Aneurysmal Bone Cyst in the Maxilla: A Case Report

Diagnostic Challenge in Rapidly Growing Langerhans Cell Histiocytosis with Aneurysmal Bone Cyst in the Maxilla: A Case Report

Point-of-care Ultrasound to Distinguish Subgaleal and Cephalohematoma: Case Report

Pediatric skull bone defect due to epidermoid cyst

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