Skull vault epidermoid

Case contributed by Dr Chris O'Donnell

Presentation

Recent blow to left parietal region. CT scan to assess for intra-cranial injury. No previous history of malignancy.

Patient Data

Age: 80
Gender: Female
Modality: CT

Small left parietal scalp haematoma (arrow) with adjacent expansile soft tissue mass in the skull vault.  Soft tissue denisty not fat so not a dermoid. Bone margins are regular or scalloped.  Incidental right skull vault osteoma.

MRI for further clarification of CT findings

Modality: MRI

Mass shows restricted diffusion (confirmed on the ADC map indicative of epidermoid).

Case Discussion

A benign, slow-growing lesion of the skull due to aberrant epidermal inclusion in the calvarium. Differential diagnosis is Langerhans cell histiocytosis in a child/young adult, metastasis and plasmacytoma. Key to diagnosis is the intradiploic location with well-demarcated lysis expanding both the inner and outer tables of the skull and well defined borders. The MRI findings of marked restricted diffusion are typical of epidermoid.

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Case Information

rID: 30621
Case created: 22nd Aug 2014
Last edited: 20th Nov 2015
Inclusion in quiz mode: Included

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