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

Most cases of pediatric scalp and skull masses are either congenital or developmental tumors or diseases, and in many patients, these lesions are accompanied by intracranial extension. Past studies pertaining to these conditions are few, and thus clinical information is as yet inadequate.

The authors present 75 pediatric patients with 77 cases of surgically treated scalp and skull masses. The most common pathologic condition was Langerhans cell histiocytosis, followed by epidermal cysts, epidermoid and dermoids, scalp hemangiomas, and neurofibromas, in descending order. Intracranial extension was observed in three cases (4%); two cases were malignant tumors that were skull metastasis of a neuroblastoma and a lymphoma, and one case was encephalocele. Lesions followed up because of possible recurrence were 15 cases of Langerhans cell histiocytosis, eight cases of epidermoid and dermoids, two cases of malignant tumors, and one case each of desmoplastic fibroma, myxoma, fibroid dysplasia, and neurofibroma, totaling 29 cases (39%).

Although the overall incidence of intracranial extension of pediatric scalp and skull masses is very low and the presence of a malignant tumor or metastatic tumor presenting as a scalp and skull mass is rare, such masses enlarge as time progresses, and there exists a possibility of recurrent disease. Therefore, it is suggested that early surgical resection will afford favorable prognosis for the patients, and meticulous follow-up is necessary in some conditions.