Scalp and Calvarial Masses of Infants and Children

Abstract

Review of 70 children presenting with a solitary nontraumatic lump on the head revealed that 61% of the lesions were dermoid tumor, 9% were cephalhematoma deformans, 7% were eosinophilic granuloma, and 4% were occult meningoceles and encephaloceles. Most of the dermoid cysts occurred along sutural lines, but some did not. One of the eosinophilic granulomas was located over the sagittal suture. Seventeen per cent of the "lumps" had significant intracranial extension. An additional 20% of the lumps extended intracranially, but only to the dura mater. Work-up of these lesions should include initial plain skull roentgenograms to assess multiplicity and appropriate computed tomographic scans to assess possible intracranial extension.

A study of 77 cases of surgically excised scalp and skull masses in pediatric patients

“…This has been reported to comprise 7-10.8% of scalp masses in children [16,20], but we observed that it was the most common type of scalp lesion in our study, occurring in 16 of 75 cases (20.8%). Ninety percent of this condition occurs in children aged 5-15 patients as a tender mass [2,16,19,22].…”

“…According to reports by Ruge et al [20] and Martinez-Lage et al [16], scalp and skull masses that occur in infants of less than 1 year of age are atretic cephaloceles, cephalohematoma, and dermoids, in descending order of frequency, while in 1-7 aged children, the order is dermoids, LCH, and malignant tumors, and in those aged more than 8 years, the order is fibrous dysplasia, dermoids, and osteomas.…”

“…The rate of pediatric scalp and skull masses with intracranial extension has been reported to be 37-57%, while the incidence of intradural extensions is reported to be a smaller 16% [16,20]. Taking into consideration previous reports that dermoid cysts comprise 15-58.5% of pediatric scalp and skull masses and that dermal sinus tracts are found in approximately half of these dermoid cyst patients, it may be that intradural extensions may be present in more than the above reported 16%.…”

“…Taking into consideration previous reports that dermoid cysts comprise 15-58.5% of pediatric scalp and skull masses and that dermal sinus tracts are found in approximately half of these dermoid cyst patients, it may be that intradural extensions may be present in more than the above reported 16%. Although 89% of lesions have shown to be diagnosed via neuroradiological studies, the less frequently occurring metastatic tumors or fasciitis, desmoplastic fibromas, fibromatosis, and ossifying fibromas are difficult to confirm without surgical intervention [20]. Furthermore, the possibility of the presence of malignant tumors, including metastatic tumors, has been shown to be from 0 to 25% in several different series, suggesting that pathologic confirmation is essential [6,16,20].…”

“…Although 89% of lesions have shown to be diagnosed via neuroradiological studies, the less frequently occurring metastatic tumors or fasciitis, desmoplastic fibromas, fibromatosis, and ossifying fibromas are difficult to confirm without surgical intervention [20]. Furthermore, the possibility of the presence of malignant tumors, including metastatic tumors, has been shown to be from 0 to 25% in several different series, suggesting that pathologic confirmation is essential [6,16,20]. Many cases of pediatric scalp and skull masses are congenital or developmental tumors or diseases that may lead to intracranial extension, further emphasizing the need for pathologic conformation of disease after surgical removal, although the incidence of malignant conditions are not high.…”