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Dermoid cysts of the anterior fontanelle
Insights
This study reviewed 94 skull dermoid cyst cases, finding 25 over the anterior fontanelle. Most affected infants, presenting with congenital swelling, were successfully treated with surgery, with no recurrences observed.
Area of Science:
- Neurosurgery
- Pediatric Oncology
- Dermoid Cysts
Background:
- Dermoid cysts of the skull are rare congenital tumors.
- The anterior fontanelle is a common location for these cysts in pediatric patients.
- Previous studies on the incidence and characteristics of these cysts are limited.
Purpose of the Study:
- To report the largest series of anterior fontanelle dermoid cysts to date.
- To analyze the clinical presentation, treatment, and outcomes of these lesions.
- To discuss the pathology, embryology, and racial incidence of skull dermoid cysts.
Main Methods:
- Retrospective review of medical records from The Hospital for Sick Children, Toronto (1967-1980).
- Analysis of 94 cases of skull dermoid cysts, with a focus on 25 located over the anterior fontanelle.
- Review of existing literature on dermoid cysts.
Main Results:
- 25 of 94 skull dermoid cysts were located over the anterior fontanelle, representing the largest reported series.
- Patients ranged from 2 months to 13 years, with two-thirds treated before age 1.
- All patients presented with a congenital, nontender swelling; females outnumbered males 2:1. All lesions were treated successfully with various surgical approaches and showed no recurrence.
- Notably, almost all patients were of white ethnicity, supporting the hypothesis that racial incidence reflects the general population.
Conclusions:
- Dermoid cysts of the anterior fontanelle are most common in infants and present as congenital swellings.
- Surgical excision is curative with no recurrence.
- The racial distribution of these cysts mirrors that of the general population.
Abstract:
A review of the medical records at The Hospital for Sick Children in Toronto, Ontario, from 1967 through 1980 showed that, of the 94 cases of dermoid cyst of the skull treated at this institution by the neurosurgical staff, 25 were located over the anterior fontanelle. This is the largest single group of cases reported to date. The children were 2 months to 13 years of age, but two-thirds were treated before their 1st birthday. Females outnumbered males 2:1, and all of the patients presented with a nontender swelling over the anterior fontanelle, which had been present from birth. The lesions were treated by a variety of surgical approaches, all of which were curative. None of the lesions has recurred. The most interesting finding was that all but 2 of the children were white, in contrast to all previously published series. This confirms our belief that the racial incidence of dermoid cysts of the anterior fontanelle is a reflection of the general population. A review of previously published cases and the pathology and embryology of the lesion is included.