Sinus pericranii--"Don't judge a lump by its surface"

Area of Science:

• Vascular Surgery
• Pediatric Surgery
• Medical Diagnostics

Background:

• Sinus pericranii is a rare congenital vascular malformation involving abnormal communication between the superior sagittal sinus and dilated veins of the scalp.
• Diagnosis can be challenging due to its variable presentation and potential misdiagnosis as other scalp lesions.
• Understanding the embryological basis and anatomical variations is crucial for accurate diagnosis and management.

Observation:

• A case of sinus pericranii initially presenting as a palpable scalp mass, misdiagnosed as a simple cyst in the community setting.
• The lesion exhibited pulsatility and increased in size with crying, suggesting a vascular origin.
• Advanced imaging, including ultrasound and MRI, was essential in confirming the diagnosis and delineating the extent of the malformation.

Findings:

• Successful surgical management of the sinus pericranii was achieved through a multidisciplinary approach.
• Histopathological examination confirmed the vascular nature of the malformation, ruling out neoplastic or cystic processes.
• The case underscores the importance of considering rare vascular anomalies in the differential diagnosis of scalp masses.

Implications:

• This case provides valuable teaching insights into the recognition and management of sinus pericranii.
• Early and accurate diagnosis can prevent complications and guide appropriate surgical intervention.
• Highlighting such unusual cases improves the collective understanding and diagnostic capabilities within the medical community for rare vascular malformations.