Scalp and Skull Neoplasms

Scalp and skull neoplasms in children are a diverse group of tumors that arise from the skin, subcutaneous tissue, bone (calvaria), or even from embryonic remnants. These tumors may be benign or malignant, and although they often appear as painless swellings, some can be locally aggressive or extend into the brain. In Bangladesh, due to lack of awareness, delayed presentation, and limited pediatric neurosurgical access, many children with scalp or skull masses are misdiagnosed or inadequately treated. At NINS and Bangladesh Paediatric Neurocare Centre, Dr. Md. Nafaur Rahman offers state-of-the-art evaluation, surgical treatment, and long-term follow-up for these rare but important conditions. Types of Scalp and Skull Tumors in Children Pediatric scalp and skull neoplasms can be classified based on origin: 1. Congenital Lesions Dermoid and Epidermoid Cysts – Commonly seen near the midline; may contain hair or skin elements Encephaloceles – Herniation of brain tissue through a skull defect (requires urgent surgery) Sinus Pericranii – Abnormal venous connection between brain and scalp Vascular Malformations (e.g., hemangiomas, AVMs) 2. Benign Neoplasms Osteomas – Dense bony growths Langerhans Cell Histiocytosis (LCH) – Can present as solitary or multiple skull lesions Fibrous Dysplasia – Abnormal bone development often involving the skull Lipomas – Fatty masses in the scalp Neurofibromas – Associated with Neurofibromatosis Type 1 (NF1) 3. Malignant Tumors Ewing’s Sarcoma – Aggressive bone tumor; requires combined treatment Rhabdomyosarcoma – Affects soft tissue of scalp and orbit Metastatic Lesions – Rare in children, but possible from neuroblastoma or leukemia Primitive Neuroectodermal Tumors (PNETs) – Highly malignant, needs urgent treatment Clinical Features of Scalp and Skull Tumors Early detection can be life-saving. Parents should watch for: Painless lump on the scalp or skull Rapid increase in size Discoloration or ulceration of skin over the lump Bone deformity or asymmetry of skull Headache, vomiting, or seizures (if there is brain involvement) Signs of raised intracranial pressure Neurological deficits or irritability in infants In Bangladesh, such lumps are sometimes dismissed as birth marks or “fatty tumors” by local practitioners, leading to late intervention. Diagnosis and Evaluation A thorough evaluation is essential to differentiate between benign and malignant, intra- and extracranial, or vascular and solid lesions. At Dr. Nafaur’s centers, the work-up includes: MRI Brain & Skull with Contrast – Identifies tumor extension, brain involvement, and precise anatomy CT Scan with 3D Skull Reconstruction – Useful for bone tumors and surgical planning Ultrasound (USG) – For superficial scalp lesions in infants Biopsy or FNAC – For histological diagnosis in selected cases Blood tests – To rule out systemic disease or infection Tumor markers – If malignancy is suspected All investigations are available at NINS and BP Neurocare Centre, under the direct care of Dr. Md. Nafaur Rahman. Surgical Treatment of Scalp and Skull Tumors The mainstay of treatment for most scalp and skull tumors is surgical excision. Surgery can be curative, diagnostic, or palliative, depending on the type and location of the lesion. Surgical Goals: Complete tumor removal Preserve underlying brain and vital structures Reconstruct the skull defect (cranioplasty) if needed Minimize scarring and cosmetic deformity Surgical Techniques: Minimally invasive excision for superficial lesions Craniotomy with skull reconstruction for deep or bone-invasive tumors Image-guided surgery using neuronavigation Multidisciplinary approach with plastic and reconstructive surgeons when needed Endoscopic assistance for certain midline or intradural lesions “Each child’s skull and scalp anatomy is unique. In pediatric neurosurgery, surgical finesse is as important as complete tumor removal.” — Dr. Md. Nafaur Rahman Adjuvant Therapy & Follow-Up Radiotherapy or chemotherapy may be needed for malignant tumors like Ewing’s sarcoma or rhabdomyosarcoma. Regular MRI or CT scans are essential for early detection of recurrence. Psychosocial support and cosmetic rehabilitation are provided as needed. Long-term monitoring of growth and skull development, especially if cranioplasty was done. Bangladesh Perspective: Need for Early Detection & Access Despite being surgically treatable, many scalp and skull tumors in Bangladeshi children are missed, misdiagnosed, or poorly managed, leading to preventable complications. Challenges include: Lack of awareness among general physicians Limited pediatric neurosurgical services outside major cities Delay in performing MRI or CT due to cost Misinterpretation of tumors as abscesses or “birthmarks” Dr. Md. Nafaur Rahman is committed to overcoming these barriers by offering: Affordable, expert care Parental counseling and education Timely surgery using the latest techniques Coordination with pediatric oncology and reconstructive surgery units Why Trust Dr. Md. Nafaur Rahman? Renowned pediatric neurosurgeon with special interest in scalp/skull tumors Operates at NINS, Bangladesh’s top neurosurgical institute Uses advanced tools including navigation and endoscopy Skilled in cosmetic reconstruction of skull and scalp defects Dedicated to providing Bangladesh’s children with world-class neurosurgical care Contact for Pediatric Skull and Scalp Tumor Consultation Dr. Md. Nafaur Rahman Assistant Professor, Pediatric Neurosurgery, NINS Chief Consultant, Bangladesh Paediatric Neurocare Centre For Serial/Appointment: 01912988182 | 01607033535 Website: www.neurosurgeonnafaur.com