Radiological Approach to Osteolytic Benign Calvarial Lesions

Öz

Histopathologically, calvarial lesions are congenital, inflammatory, neoplastic and traumatic origin and these are rarely seen. The calvarial lesions most commonly manifest as palpable mass on physical examination or they are diagnosed incidentally during a radiological test. Defect, lysis and sclerosis in the bony structure are evaluated with radiography and computed tomography (CT) and relationships of the lesions with the soft tissue components and surrounding soft tissue are evaluated with CT and magnetic resonance imaging (MRI) and especially with MRI. Based on the radiological findings, benign-malignant discrimination of the calvarial lesions can be made and it may be possible to estimate their histopathological diagnoses.

Anahtar Kelimeler

• calvarial lesions,radiography,computed tomography; magnetic resonance imaging

Osteolitik Benign Kalvarial Kitlelere Radyolojik Yaklaşım

Öz

Kalvarial lezyonlar histopatolojik olarak, kongenital, enflamatuar, neoplastik ve travmatik kökenli olup, nadir olarak izlenmektedir. Kalvarial lezyonlar en sık klinik muayenede ele gelen kitle şeklinde ya da radyolojik bir tetkikde insidental olarak tanı konur. Kemik yapıdaki defekt, lizis ve skleroz radyografi ve bilgisayarlı tomografi (BT) ile, lezyonların yumuşak doku komponentleri ve çevre yumuşak doku ile ilişkisi, BT ve manyetik rezonans görüntüleme (MRG) ile ve özelikle MRG ile değerlendirilir. Radyolojik değerlendirme sonucu, radyolojik bulgulara göre kalvarial lezyonların benignmalign ayrımı ve histopatolojik tanısını tahmin etmek mümkün olmaktadır.

Anahtar Kelimeler

• kalvarial lezyonlar,radyografi,bilgisayarlı tomografi; manyetik rezonans görüntüleme

Kaynakça

1. 1. Gibson SE, Prayson RA. Primary skull lesions in the pediatric population: a 25-year experience. Arch Pathol Lab Med 2007;131(5):761–6.
2. 2. Moron FE, Morriss MC, Jones JJ, Hunter JV. Lumps and bumps on the head in children: use of CT and MR imaging in solving the clinical diagnostic dilemma. Radiograph 2004;24(6):1655–74.
3. 3. Burgener FA, Kormano M. Differential diagnosis in conventional radiolog y. New York: Georg Thieme Verlag 2nd ed1991. p.139–46.
4. 4. Amaral L, Chiurciu M, Almeid JRI, Ferreira NF, Mendonça R, Lima SS. MR imaging for evaluation of lesions of the cranial vault: a pictorial essay. Arq Neuropsiquiatr 2003;61(3A):521–32.
5. 5. Russel DS, Rubinstein LS. Tumors and tumorlike conditions of maldevelopment ori. In: Russel DS RL, editor. Patholog y of tumors of nervous system 5th ed. London: Edward Arnold; 1989. p.693–8.
6. 6. Pannell BW, Hendrick EB, Hoffman HJ, Humphreys RP. Dermoid cysts of the anterior fontanelle. Neurosurg 1982;10(3):317–23.
7. 7. Saito T, Yuki K, Kaziwara Y, Sasaki T, Imada Y, Kodama Y. An intradiploic epidermoid cyst of the skull in infancy: case report. No Shinkei Geka 2002;30(6):647–50.
8. 8. Schonauer C, Conrad M, Barbato R, Capuano C, Moraci A.Traumatic rupture into frontal sinus of a frontal intradiploic epidermoid cyst. Acta Neurochir (Wien) 2002;144(4):401–2.

9. 9.Chen S, Ikawa F, Kurisu K, Arita K, Takaba J, Kanou Y. Quantitative MR evaluation of intracranial epidermoid tumors by fast fluid-attenuated inversion recovery imaging and echo-planar diffusion-weighted imaging. AJNR Am J Neuroradiol 2001;22(6):1089–96.
10. 10. Dutt SN, Mirza S, Chavda SV, Irving RM. Radiologic differentiation of intracranial epidermoids from arachnoid cysts. Otolog y & neurotolog y: official publication of the American Otological Society, American Neurotolog y Society and European Academy of Otolog y and Neurotolog y 2002;23(1):84–92.
11. 11. Yalcin O, Yildirim T, Kizilkilic O, Hürcan CE, Koç Z, Aydin V, et al. CT and MRI findings in calvarial non-infectious lesions. Diagn Interv Radiol 2007;13(2):68–74.
12. 12. Martinez-Lage JF, Poza M, Sola J, Soler CL, Montalvo CG, Domingo R, et al. The child with a cephalocele: etiolog y, neuroimaging, and outcome. Childs Nerv Syst 1996;12(9):540–50.
13. 13. Choi HJ, Cho CW, Kim YS, Cha JH. Giant arachnoid granulation misdiagnosed as transverse sinus thrombosis. J Korean Neurosurg Soc 2008;43(1):48–50.
14. 14. Haroun AA, Mahafza WS, Al Najar MS. Arachnoid granulations in the cerebral dural sinuses as demonstrated by contrast-enhanced 3D magnetic resonance venography. Surg Radiol Anat 2007;29(4):323–8.
15. 15. Haybaeck J, Silye R, Soffer D. Dural arachnoid granulations and “giant” arachnoid granulations. Surg Radiol Anat 2008;30(5):417–21.
16. 16. Kan P, Stevens EA, Couldwell WT. Incidental giant arachnoid granulation. AJNR Am J Neuroradiol 2006;27(7):1491–2.
17. 17. Leach JL, Meyer K, Jones BV, Tomsick TA. . Large arachnoid granulations involving the dorsal superior sagittal sinus: findings on MR imaging and MR venography. AJNR Am J Neuroradiol 2008;29(7):1335–9.
18. 18. Trimble CR, Harnsberger HR, Castillo M, Brant-Zawadzki M, Osborn AG. ”Giant” arachnoid granulations just like CSF?: NOT!! AJNR Am J Neuroradiol 2010;31(9):1724–8.
19. 19. Chong VFH, Khoo JBK, Fan Y-F. Fibrous dysplasia involving the base of the skull. AJR Am J Roentgenol 2002;178(3):717–20.
20. 20. Hamilton HB, Voorhies RM. Tumors of the skull. In Wilkins RH, Rengachary SS (eds): Neurosurgery. IIA. New York: McGraw Hill; 1996. p.1503–82.
21. 21. Binning MJ, Brockmeyer DL. Novel multidisciplinary approach for treatment of langerhans cell histiocytosis of the skull base. Skull Base 2008;18(1):53–8.
22. 22. Loret I, Server A, Taksdal I, Calvarial lesions: aradiological approach to diagnosis. ActaRadiol 2009;50(5):531–42.