Epidermoids and dermoids of the calvarian bones in early childhood: Their behaviour in the growing skull

Abstract

Thirteen out of 25 cystic lesions of the infantile skull, radiographically classified as epidermoids or dermoids of the calvarian bones, disappeared spontaneously during early childhood. A further six lesions showed involution. In all, 19/25 lesions were involutive. In no case did we find an enlargement which could be attributed with certainly, to growth after the age of 3 years. These findings strongly support the opinion of Fauré that by far most of these lesions are non-evolutive and generally do not need surgical treatment. Only lesions which do persist beyond the third year of life and grow continuously or begin to grow again need to be operated. Thus, we recommend a conservative attitude and a radiographic follow-up at long intervals.

Pseudotumour cerebri due to a torcular epidermoid cyst

“…Thomas and Baker reported that 40% of all patients undergoing X‐ray studies of their skull demonstrate calvarial lucencies, 3% of which are epidermoids 17 . In contrast, Holthusen et al identified 15 cases (0.065%) of calvarial epidermoids and dermoids in 22 853 consecutive skull X‐ray examinations of children up to 15 years of age over a decade 18 . At the time of diagnosis 88% of their patients were under 3 years of age.…”

Wild duck strikes again

“…17 In contrast, Holthusen et al identified 15 cases (0.065%) of calvarial epidermoids and dermoids in 22 853 consecutive skull X-ray examinations of children up to 15 years of age over a decade. 18 At the time of diagnosis 88% of their patients were under 3 years of age. Interestingly, of the 25 patients who were followed up in their series, 13 lesions spontaneously regressed while six others demonstrated involution.…”

Langerhans cell histiocytosis or tuberculosis on a medieval child (Oppidum de la Granède, Millau, France – 10th–11th centuries AD)

“…Osteolytic cancer can be excluded because of the age (Resnick 2002) as well as dermoid and epidermoid cysts [58] for which size (less than 25 mm diameter), shape (well defined, round or oval with sclerotic merge), and location (typically frontal bone and terminal phalanges of hands) of the lesions appear to be different. Sarcoidosis [25] affects young adults, especially hand and foot phalanges.…”