Madhavi Thatipamula1, Sudha Bindu Tirumani2, Sunitha Thaluri3, Vijaya Kumari Mudunoor4
BACKGROUND
Paediatric calvarial mass lesions are common and can have prognostic and
therapeutic implications based on the type of lesions. The spectrum of lesions can
extend from benign lesions like cephalhaematoma, which is a common postnatal
swelling in the paediatric scalp to severe lesions like neuroblastoma metastases.
Therefore, proper diagnosis of these lesions is of prime importance in day to day
practice which can help in accurate management of these lesions. This study was
conducted to evaluate the role of computed tomography (CT) in the assessment
of paediatric calvarial masses.
METHODS
In our prospective observational study, during a period of 1 year (October 2019
to October 2020) 26 children with visible swelling on the calvarium were subjected
to CT examination. The imaging features of various paediatric calvarial lesions on
CT were noted.
RESULTS
Out of 26 paediatric patients, which included infants from 1 day of life to children
of 7 years age, the most common age of presentation was less than one-year age
group. The most common type of calvarial mass lesion was cephalhaematoma and
the next most common mass lesion was dermoid cyst. CT could diagnose all the
lesions based on the image morphology with clear delineation of their extent. 16
cases had isolated soft tissue involvement (cephal haematoma, sub galeal
haematoma, lipoma, dermoid cyst) whereas ten lesions like encephalocele,
osteomyelitis, Langerhans cell histiocytosis (LCH), fibrous dysplasia,
neuroblastoma metastases, lymphoma deposits had both soft tissue and bone
involvement.
CONCLUSIONS
Accurate detection, characterisation and delineation of the lesions are important
in management of the various paediatric calvarial masses. CT is a useful imaging
tool in confirming the diagnosis and also for anatomical delineation in certain cases
requiring surgical management. It also helps in detecting associated intracranial
extension of the lesions.
