Calvarial Lesions: En-bloc Resection Is a Safe Surgical Procedure

Abstract

Background: Calvarium could be a target site for either primary or secondary tumors. Calvarial tumors present usually as painless palpable masses, which are asymptomatic neurologically. Objective: To perform a retrospective analysis of the calvarial lesions operated in our departments of neurosurgery. Patients and Methods: We retrospectively reviewed 41 consecutive patients operated for calvarial masses between 2014 and 2020 at Benha University Hospital and Merciful Brothers Hospital Trier. Clinical data were retrospectively analyzed. The diagnosis was confirmed by the histopathological examination. Results: Calvarial lesions included in this series were divided into 3 categories: tumorlike lesions, primary, and secondary tumors. The group of tumor-like lesions involved eosinophilic granuloma (3 patients), epidermoid cyst (3 patients), and fibrous dysplasia (5 patients). The primary tumors included hemangiomas (5 patients), osteomas (5 patients), and meningiomas (11 patients). Nine patients had metastasis. Calvarial lesions mostly presented with local swelling, sometimes local pain and rarely neurologic deficit. En-bloc resection was performed followed by cranioplasty. Pain was improved postoperatively in cases presented with painful swelling. The only postoperative complication was one case of wound infection. Conclusion: Although a thorough preoperative radiological evaluation in cases of calvarial lesions could be helpful in narrowing the diagnosis spectrum of differential diagnosis, en-bloc resection followed by cranioplasty could be considered as a valuable treatment option. The next step in treatment of such patients vary widely according to the histopathological findings.