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Vol. 47, No. 3, 2011
Issue release date: January 2012
Pediatr Neurosurg 2011;47:198–203

Primary Pediatric Skull Tumors

Hayden Gephart M.G. · Colglazier E. · Paulk K.L. · Vogel H. · Guzman R. · Edwards M.S.B.
aDepartment of Neurosurgery and bDivision of Neuropathology, Stanford University Medical Center, and cStanford University, Stanford, Calif., dDivision of Pediatric Neurosurgery, Lucile Packard Children’s Hospital, Palo Alto, Calif., USA

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Background/Aims: To review the pathological distribution of pediatric primary skull tumors, and to determine the diagnostic value of lesion location, patient age and lesion size. Methods: A retrospective chart review identified 51 consecutive pediatric patients with 54 primary skull tumors, treated between 2005 and 2010. Results: The most common diagnoses were dermoid cysts (n = 34) and fibrous dysplasia (n = 5). While dermoid tumors could reside anywhere (sensitivity = 0.41), a midline lesion had a specificity of 0.9 and a positive predictive value of 0.88. All of the fibrous dysplasia lesions were laterally placed, with a negative predictive value (NPV) of 1. Patient age < or >5 years had a high sensitivity and NPV for dermoid cysts and fibrous dysplasia, respectively. Size appeared to be sensitive (0.91, 0.8), but not specific (0.6, 0.78), with good NPV (0.8, 0.97) when considering dermoid cysts (≤2 cm) or fibrous dysplasia (>2 cm), respectively.Conclusion:Dermoid cysts followed by fibrous dysplasia are the most common primary skull tumors. Lesion location, patient age and lesion size give important clues as to the diagnosis. For the majority of cases, a clinical diagnosis based on CT is sufficient for presurgical evaluation.

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