Large Osteolytic Skull Tumor Presenting as a Small Subcutaneous Scalp Lesion

Sutherland, John P.; Dahdaleh, Nader S.; Greenlee, Jeremy D.W.; Kirby, Patricia; Sargent, Michael D.

doi:10.3122/jabfm.2011.06.100308

Cited by 4 publications

(2 citation statements)

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“…Tumors of the skull are uncommon and account for 1–4% of all bone tumors. [ 27 ] Fibrous dysplasia (FD), ossifying fibroma (OF) (aka osteofibrous dysplasia outside of the head and neck region), and desmoplastic fibroma (DF) are benign fibro-osseous tumors in the World Health Organization (WHO) classification of tumors affecting the cranium. [ 10 ] However, given that these tumors can present with very similar features diagnosis can be difficult at times.…”

Section: Introductionmentioning

confidence: 99%

Fibro-osseous lesion of the cranium in an adolescent patient

et al. 2015

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Background:Fibrous dysplasia, ossifying fibroma, and desmoplastic fibroma are rare benign calvarial lesions, which can have local aggressive behavior. These tumors can present with similar clinical and radiologic characteristics making diagnosis difficult at times.Case Description:A 16-year-old male presents after noting an indentation of his skull. Comparison with current and previous imaging revealed progressive erosion of the skull underlying the indentation.Conclusion:Fibrous dysplasia, ossifying fibroma, and desmoplastic fibroma are rare fibro-osseous tumors with similar characteristics radiographically. Accurate diagnosis of these tumors can be difficult even with the combination of clinical presentation, imaging, and pathology. The treatment of choice is resection and cranial reconstruction, if necessary, with close follow-up as recurrence can occur.

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Section: Introductionmentioning

confidence: 99%

Fibro-osseous lesion of the cranium in an adolescent patient

et al. 2015

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“…White and Magee 18 provide a case example with key findings and actions to take. In another brief report, Sutherland et al 19 provide a reminder to ask, Is this mass as superficial as it seems, or could it be deeper and more difficult to remove?…”

Section: Other Topicsmentioning

confidence: 99%

Change, Lack of Change, and Creating Optimal Change Out of Chaos

Bowman¹,

Neale²

2011

The Journal of the American Board of Family Medicine

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Once again, we consider how to effect practice change at the local and national levels. This issue includes several articles that relate to quality improvement. Some physician actions seem resistant to change, as do the underlying social determinants and processes that lead to what are thought to be avoidable hospitalizations, but we also find that concerted effort, along with standardized orders sets and other avenues, can make a difference. Sometimes, however, our attempts at change can lead to more distraction then efficacy. Here we include articles that place the quality issues in context, report interventions, and advance the types of specific knowledge that allow interventional trials. We also have several articles about cancer screening and follow-up, a subset of quality improvement. Quality ImprovementBaird 1 provides us with a fascinating historic and nuanced reflection of how and whether medical homes represent something new or otherwise different from former attempts at reform in family medicine, specifically managed care. In light of previous inflated expectations of the ways in which reforms can change medical care, he says, "no villains allowed."Information chaos is clearly one of the reasons that we struggle to improve quality to a desired level. Beasley and colleagues 2 provide a structure to consider the information chaos, the negative outcomes of the chaos, and some direction for future research. This construct also relates to our tonguein-cheek, yet provocative, selection from Baxley et al.3 who suggests that we sometimes act as if we have attention deficit disorder as we attempt to implement multiple concurrent Plan-Do-StudyAct practice improvement projects. It is a variant of a "quality improvement disorder." Therefore, some remedies are in order. However, the answer is not to just take a pill daily and hope it will go away. Hopefully, we can improve the quality of our quality improvement activities.In one major attempt to improve health care nationally, the Affordable Care Act mandates that the Centers for Medicaid and Medicare Services (CMS) implement a 10% payment increase for primary care. CMS criteria defining primary care are unfortunately currently inadequate to the task because they exclude many family physicians, particularly those in more rural settings or those who provide a broader range of services, as documented by research from the Robert Graham Center. 4 On to specific examples from the articles in this issue. We know that preventable hospitalizations vary by location, but just how easy are these to avert? Sumner et al 5 determined that the differences in preventable hospitalizations between the counties in Kentucky persisted over time. This suggests that underlying problems or processes are not readily changed, and that needed health care improvements will be relatively resistant to transformation.Another specific quality improvement item that seems resistant to change is the ordering of urine cultures for women with urinary tract infection symptoms. Obtaining urine culture...

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Differential Diagnoses: Clinical and Imaging

Akhaddar

2016

Cranial Osteomyelitis

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Large Osteolytic Skull Tumor Presenting as a Small Subcutaneous Scalp Lesion

Cited by 4 publications

References 10 publications

Fibro-osseous lesion of the cranium in an adolescent patient

Fibro-osseous lesion of the cranium in an adolescent patient

Change, Lack of Change, and Creating Optimal Change Out of Chaos

Differential Diagnoses: Clinical and Imaging

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