Spectrum of Skull Lesions in Pediatric Population: A Single Institutional Experience
Keywords:
Skull lesions, painless massAbstract
Background: Pediatric skull lesions are rare. Here, a single institutional experience dealing with such lesions is presented.
Methods: A retrospective review of 18 consecutive pediatric patients was done, who were treated for a variety of skull lesions at Department of Neurosurgery, King Faisal Specialist Hospital and Research Centre, Riyadh from 2010 to 2015. The clinical and pathological features, diagnosis, management and outcome were noted and analyzed.
Results: In this study, eighteen skull lesions were identified in 10 male (55%) and 8 female (44%) patients, with a mean age at diagnosis of 9.5 years. These lesions were usually benign and most commonly presented as a painless mass (n = 11). Fronto-orbital (n = 6) was the most frequent site encountered in this study followed by temporo-parietal (n = 3) and parieto-occipital area (n = 2). Gross total resection achieved in 15 patients (83.3%) and reconstruction of skull defect was possible in 11 (61.1%) of them. Excluding the malignant lesions, no recurrence was found in this study cohort for a mean follow up time of 2.8 years.
Conclusions: Majority of the skull lesions in children are benign. Pre-operative angiography and embolization is helpful to reduce the intraoperative blood loss. Gross total resection with reconstruction is the treatment of choice. Recurrence is uncommon after gross total resection.
References
2. Gibson SE, Prayson RA: Primary skull lesions in pae-diatric population: A 25 years experience. Arch Pathol Lab Med. 2007; 131: 761-766.
3. Martinez – Lage, J. F., A. Capel, T. R. Costa, M. A. Perez – Espejo, and M. Poza. The child with a mass on its head: diagnostic and surgical strategies. Childs Nerv Syst. 1992; 8: 247–252. [Cross Ref]
4. Cummings, T. J., T. M. George, H. E. Fuchs, and R. E. McLendon. The pathology of extracranial scalp and skull masses in young children. Clin Neuropathol. 2004; 23: 34–43. [Medline]
5. Ruge, J. R., T. Tomita, T. P. Naidich, Y. S. Hahn, and D. G. McLone. Scalp and calvarial masses of infants and children. Neurosurgery, 1988. 22: 1037–1042. [Cross Ref]
6. Arana, E., F. F. Latorre, and A. Revert. et al. Intra-diploic epidermoid cysts. Neuroradiology, 1996; 38: 306–311. [Cross Ref]
Pryor, S. G., J. E. Lewis, A. L. Weaver, and L. J. Orvi-das. Pediatric dermoid cysts of the head and neck. Oto-laryngol Head Neck Surg. 2005; 132: 938–942. [Cross Ref]
8. Pannell, B. W., E. B. Hendrick, H. J. Hoffman, and R. P. Humphreys. Dermoid cysts of the anterior fontanelle. Neurosurgery, 1982; 10: 317–322. [Cross Ref]
9. Lieberman, P. H., C. R. Jones, and R. M. Steinman, et al. Langerhans cell (eosinophilic) granulomatosis: a clinicopathologic study encompassing 50 years. Am J Surg Pathol. 1996; 20: 519–552. [Cross Ref]
10. Moron, F. E., M. C. Morriss, J. J. Jones, and J. V. Hun-ter. Lumps and bumps on the head in children: use of CT and MR imaging in solving the clinical diagnostic dilemma. Radiographics, 2004; 24: 1655–1674. [Cross Ref] [Medline]
11. Willatt, J. M. and G. Quaghebeur. Calvarial masses in infants and children: a radiological approach. Clin Radiol. 2004; 59: 474–486. [Cross Ref]
12. Frassica, F.J, R.L Waltrip, P.D. Sponseller, L.D. Ma, and E.F. McCarthy, Clinicopathologic features and tre-atment of osteoid osteoma and osteoblastoma in chil-dren and adolescents. Orthop. Cliun North Am. 1996; 27: 559-574.
Downloads
Published
Issue
Section
License
The work published by PJNS is licensed under a Creative Commons Attribution-NonCommercial 4.0 International (CC BY-NC 4.0). Copyrights on any open access article published by Pakistan Journal of Neurological Surgery are retained by the author(s).
