Clinical Characteristics of Benign Pediatric Cranial Vault Tumors: Surgical Considerations Based on 100 Cases.
OBJECTIVE
Tumors of the cranial vault occur at every age of childhood. Although they are mostly benign lesions, their symptomatology is variable and requires extended diagnostics. The choice of therapeutic strategy strongly depends on histopathological diagnosis, and therefore surgical excision is the elective treatment in such cases. Despite several published papers, the literature still lacks reliable clinical characteristics regarding this heterogeneous group of lesions in pediatric patients.


METHODS
We present a series of 100 children (55 male, 45 female) with scalp and cranial vault masses (average age: 3.6 years; range: 1 month to 17 years). Eighty-three (83%) patients underwent surgical excision. Demographic data, clinical presentation, diagnostic studies, choice of therapy, and the results of treatment were evaluated.


RESULTS
All removed tumors were benign pathologies: pilar cysts (30%), epidermoid/dermoid cysts (21%), vascular malformations (11%), inflammatory tumors (5%), and dysraphic remnants (2%). However, underlying bone destruction was observed in 61% of cases. Cranial extension occurred in 34%. Recurrence was noted in 1 case.


CONCLUSIONS
Cranial vault tumors are characterized by constant growth and may penetrate the cranial cavity. Delayed surgery increases the risk of intracranial complications. Surgical problems include inappropriate planning, higher risk of intraoperative bleeding, and the need for subsequent cranioplasty.
Department of Pediatric Neurosurgery, Bogdanowicz Memorial Hospital for Children, and Department of Descriptive and Clinical Anatomy, Medical University of Warsaw, Warsaw, Poland.
Tymon
T
Skadorwa
Bogdan
B
Ciszek
D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D011300:Preoperative Care / Q000379:methods* / Q000592:standards; D012878:Skin Neoplasms / Q000000981:diagnostic imaging* / Q000601:surgery*; D012888:Skull Neoplasms / Q000000981:diagnostic imaging* / Q000601:surgery*