CT and MRI features of scalp lesions
AbstractScalp lesions can be classified as congenital, traumatic, inflammatory, or neoplastic in origin. Although patients presenting with scalp masses are frequently seen in daily practice, differentiation of scalp lesions is often challenging for radiologists who are not familiar with the imaging of cutaneous lesions. The majority of scalp lesions are fortunately benign, with cystic lesions accounting for over 50% of all benign scalp lesions. Such lesions include trichilemmal cysts (pilar cysts), sebaceoma, epidermoid cysts, dermoid cysts, and teratoid cysts. Radiologists may also occasionally encounter benign neoplasms of the scalp, including melanocytic nevi, keratoacanthoma, pilomatricoma, neurofibroma, and lipoma. Malignant scalp tumors are uncommon; however, they carry a potential risk of delayed detection, resulting in poorer outcomes. Most scalp lesions show nonspecific imaging findings, although some possess characteristic features on CT and MRI. Radiologists must be familiar with the appearances of common scalp lesions to reach an accurate diagnosis. Hence, the aim of this article is to describe the clinical and imaging features of scalp lesions.
ConclusionCLE is a useful tool for prediction of histology to assess the polypoidal lesions of the GI tract, and it may avoid polypectomy at least in some patients.
Abstract: In our routine and consultative pathology practices, we have noticed that a relatively high proportion of spindle cell predominant trichodiscomas demonstrate a remarkable stromal admixture of adipose tissue, which along with spindle cells, prominent collagen bundles and myxoid change closely resembles spindle cell lipoma (SCL). To clarify their possible relationship to SCL, 25 cases of trichodiscoma and fibrofolliculoma with stromal “lipomatous metaplasia” were collected and examined using immunohistochemical stains [CD34 and retinoblastoma-1 (RB1) protein] and fluorescence in situ hybridization (RB...
Introduction: Pediatric midline lesions of the scalp evoke a large differential diagnosis, including hemangiomas, lipomas, and developmental anomalies such as cephaloceles, meningoceles, aplasia cutis congenita, dermoid cysts, and leptomeningeal cysts.
We report the successful use of intralesional deoxycholic acid in reducing the size of a large lipoma prior to excision.
Although rare, the Sister Mary Joseph Nodule is considered the most common presentation of cutaneous metastatic gastrointestinal adenocarcinoma, arising as a solitary umbilical nodule. This case represents an example of atypical, nonumbilical, metastatic pancreaticobiliary adenocarcinoma, ominously disguised as more innocuous lesions on the extremities. A 63-year-old Caucasian female with discoid lupus was referred for a 6-week history of subcutaneous nodules on the extremities. She described a long history of lipomas but noted that the current lesions were distinctly tender.
Merkel cell carcinoma (MCC) is a rare malignancy of neuroendocrine origin that often presents with a cutaneous nodule in sun-exposed areas. The most common demographic affected is white males in the seventh to eighth decades of life, with risk factors including sun exposure, fair skin, advanced age, and immunosuppression. While the incidence is low compared with melanoma, it has been increasing over the last three decades. A violaceous to blue nodule is most commonly found, but there have been reports in the literature of MCC presenting as benign dermatologic lesions such as epidermal inclusion cysts and lipomas.
ConclusionsAt a tertiary musculoskeletal oncology referral clinic, primary STMs ≤ 2 cm with indeterminate imaging features should be managed cautiously despite their small size and/or superficial location.
In conclusion misdiagnosis of an isolated painless axillary mass as a lipoma, as occurred in our patient, allowed this malignancy to reach considerable size. The progressive neurology provided the red flag for urgent surgical intervention.
ConclusionsWe present a rare case of an embryological “collision” of an intramedullary dermoid cyst associated with filar lipoma underlining the spectrum of intradural pathologies in spinal dysraphism. Surgical management is creative in these circumstances and multimodal. Our surgical management shows that the use of endoscopes can be effective in the surgical removal of long sectional spinal dermoid cysts.
We describe a case of new spinal mass causing CC, referred for radiotherapy for presumed malignancy, and ultimately proven via biopsy to be benign PDB. This is the first documented case of CC as the primary presentation of vertebral PDB mimicking malignancy. Suggested within is a diagnostic approach for unknown lesion causing CC that facilitates pathologic diagnosis while minimizing treatment delays.