Erdem Yılmaz1, Aylin Yetim2, Oğuz Bülent Erol3, Melih Pekcan1, Ensar Yekeler3. 1. Department of Radiology, İstanbul University İstanbul Faculty of Medicine, İstanbul, Turkey. 2. Department of Pediatrics, İstanbul University İstanbul Faculty of Medicine, İstanbul, Turkey. 3. Department of Pediatric Radiology, İstanbul University İstanbul Faculty of Medicine, İstanbul, Turkey.
Abstract
BACKGROUND: Calvarial lesions are often detected incidentally in routine radiology. Most lytic lesions of the skull are benign. Enlarged parietal foramina are benign lesions caused by deficient intramembranous ossification. CASE REPORT: An 11 month-old female patient was admitted with a mass on the right of the back of the head. Physical examination showed a soft 5 cm mass area with no palpable bone in the right occipital. The family history revealed a similar mass in a maternal cousin that resolved over time. Craniography showed lytic lesions, and there were no other pathologies on a complete skeletal X-ray. Computed tomography (CT) showed regular-shaped defects in the bilateral temporal bones, right parietal bone, bilateral frontal bones in the upper-medial orbital wall, and particularly in the occipital bone. The well-defined contours, absence of a soft tissue component, and normal structure and density of the adjacent calvarial bones all pointed to a congenital defect. No change in the lesions was observed during a three-year ultrasound follow-up period. CONCLUSION: To the best of our knowledge, this is the first described case of multiple occipital, parietal, temporal, and frontal foramina in the cranium. A diagnosis of enlarged parietal foramina variant should be considered after ruling out the differential diagnosis in patients with multiple calvarial lesions. CT may provide valuable findings for the differential diagnosis, and sonography may be used for follow-up.
BACKGROUND: Calvarial lesions are often detected incidentally in routine radiology. Most lytic lesions of the skull are benign. Enlarged parietal foramina are benign lesions caused by deficient intramembranous ossification. CASE REPORT: An 11 month-old female patient was admitted with a mass on the right of the back of the head. Physical examination showed a soft 5 cm mass area with no palpable bone in the right occipital. The family history revealed a similar mass in a maternal cousin that resolved over time. Craniography showed lytic lesions, and there were no other pathologies on a complete skeletal X-ray. Computed tomography (CT) showed regular-shaped defects in the bilateral temporal bones, right parietal bone, bilateral frontal bones in the upper-medial orbital wall, and particularly in the occipital bone. The well-defined contours, absence of a soft tissue component, and normal structure and density of the adjacent calvarial bones all pointed to a congenital defect. No change in the lesions was observed during a three-year ultrasound follow-up period. CONCLUSION: To the best of our knowledge, this is the first described case of multiple occipital, parietal, temporal, and frontal foramina in the cranium. A diagnosis of enlarged parietal foramina variant should be considered after ruling out the differential diagnosis in patients with multiple calvarial lesions. CT may provide valuable findings for the differential diagnosis, and sonography may be used for follow-up.
Authors: H Y B Chung; T Uster-Friedberg; S Pentaz; S Blaser; K Murphy; D Chitayat Journal: Ultrasound Obstet Gynecol Date: 2010-10 Impact factor: 7.299
Authors: Ronald B J Glass; Sandra K Fernbach; Karen I Norton; Paul S Choi; Thomas P Naidich Journal: Radiographics Date: 2004 Mar-Apr Impact factor: 5.333