Dermoid and epidermoid cysts are uncommon masses in the head and neck region of children, and most commonly involve the midline.2-4 Although the most common reported lesion is the dermoid cyst, but the spectrum of pathologies in these lesions can present diagnostic challenges to the treating surgeon.1,5 As in present case, skull radiographs demonstrate a lytic lesion surrounded by a sclerotic rim typical of dermoid cyst of the cranium.4 Expansion and erosion of the cranial bones are even rarer; however, these tumors may expand (1) laterally in the cranial bones, (2) externally to present as masses in the scalp or facial region, or (3) internally to involve the intracranial contents.6,7 High-risk cases can be identified by clinical and radiological features, confirmed by a computed tomographic scan, and then referred for neurosurgical treatment.6 In calvarial masses of uncertain nature, surgical excision both for diagnosis and for treatment is recommended.4 Present case signifies that scalp abscess in a child may have these types of lesions and needs further work up, histopathological confirmation, and definite treatment.
1. Cummings TJ, George TM, Fuchs HE, et al. The pathology of extracranial scalp and skull masses in young children. Clin Neuropathol
2. Stokes RB, Saunders CJ, Thaller SR. Bregmatic epidermoid inclusion cyst eroding both calvarial tables. J Craniofac Surg
3. Lebkowski WJ, Lebkowska U, Dzieciol J. The giant dermoid cyst of the scalp mimicking skull tumour. Case report. Rocz Akad Med Bialymst
4. Martinez-Lage JF, Garcia S, Torroba A, et al. Unusual osteolytic midline lesion of the skull: benign osteoblastoma of the parietal bone. Childs Nerv Syst
5. Peter JC, Sinclair-Smith C, De Villiers JC. The congenital bregmatic dermoid: an African cyst? Br J Neurosurg
6. Crawford R. Dermoid cyst of the scalp: intracranial extension. J Pediatr Surg
7. Wax MK, Briant TD. Epidermoid cysts of the cranial bones. Head Neck