Primary pediatric skull tumors.
OBJECTIVE
To review the pathological distribution of pediatric primary skull tumors, and to determine the diagnostic value of lesion location, patient age and lesion size.


METHODS
A retrospective chart review identified 51 consecutive pediatric patients with 54 primary skull tumors, treated between 2005 and 2010.


RESULTS
The most common diagnoses were dermoid cysts (n = 34) and fibrous dysplasia (n = 5). While dermoid tumors could reside anywhere (sensitivity = 0.41), a midline lesion had a specificity of 0.9 and a positive predictive value of 0.88. All of the fibrous dysplasia lesions were laterally placed, with a negative predictive value (NPV) of 1. Patient age < or >5 years had a high sensitivity and NPV for dermoid cysts and fibrous dysplasia, respectively. Size appeared to be sensitive (0.91, 0.8), but not specific (0.6, 0.78), with good NPV (0.8, 0.97) when considering dermoid cysts (≤2 cm) or fibrous dysplasia (>2 cm), respectively.


CONCLUSIONS
Dermoid cysts followed by fibrous dysplasia are the most common primary skull tumors. Lesion location, patient age and lesion size give important clues as to the diagnosis. For the majority of cases, a clinical diagnosis based on CT is sufficient for presurgical evaluation.
Department of Neurosurgery, Stanford University Medical Center, Stanford, CA 94305, USA.
Melanie G
MG
Hayden Gephart
Elizabeth
E
Colglazier
Kayla L
KL
Paulk
Hannes
H
Vogel
Raphael
R
Guzman
Michael S B
MS
Edwards
D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D015331:Cohort Studies; D003884:Dermoid Cyst / Q000000981:diagnostic imaging* / Q000601:surgery; D005260:Female; D005357:Fibrous Dysplasia of Bone / Q000000981:diagnostic imaging* / Q000601:surgery; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D011237:Predictive Value of Tests; D011300:Preoperative Care; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D012886:Skull / Q000000981:diagnostic imaging*; D012888:Skull Neoplasms / Q000000981:diagnostic imaging* / Q000601:surgery; D014057:Tomography, X-Ray Computed