Turkish Neurosurgery 2016 , Vol 26 , Num 5
Management of Calvarial Tumors: A Retrospective Analysis and Literature Review
Erkin OZGIRAY1, Karthikeyan PERUMAL2, Celal CINAR3, Kadir Emre CALISKAN1, Yesim ERTAN4, Taskin YURTSEVEN1, Nezih OKTAR1, Izzet OVUL1, Kazim ONER1
1Ege University, School of Medicine, Department of Neurosurgery, Izmir, Turkey
2Illinois Institute of Technology, Department of Health Physics, Chicago, IL, USA
3Ege University, School of Medicine, Department of Radiology, Izmir, Turkey
4Ege University, School of Medicine, Department of Pathology, Izmir, Turkey
DOI : 10.5137/1019-5149.JTN.12537-15.0 AIM: Tumors of various organs that metastasize to bone do not neglect calvarium as a target. The aim of this study was to characterize the calvarial tumors.

MATERIAL and METHODS: We retrospectively reviewed 45 consecutive patients operated for calvarial masses from January 2002 till May 2012 at our hospital. Skull base tumors and patients ≤18 years were excluded.

RESULTS: Three groups of lesions were found - calvarial metastases (15/45), primary tumors (5/45) and tumor-like lesions (25/45). Malignant lesions were equitable by gender distribution, higher age of onset (median age of primary =55; secondary = 60 years) and benign lesions by younger age (median = 35) and female bias (18/25). Calvarial metastases mostly presented with local swelling (10/15), local pain (6/15) and rarely neurologic deficit. There was associated dural sinus thrombosis (4/20 of malignant; 1/25 of benign lesions) and osteolysis (3/5 primary malignant, 13/15 secondary and 18/25 of benign lesions). Complete surgical excision was possible with minimal morbidity in all except one patient and nil mortality.

CONCLUSION: Nearly half (20/45) of the calvarial lesions tend to be malignant with most of them presenting as silent painless masses. Surgical excision should be considered only after suitable investigation and appropriate neurosurgical set-up. Keywords : Skull metastasis, Calvarial tumors, En-bloc resection, Primary tumors, Surgical approach

Corresponding author : Karthikeyan Perumal, sindash@yahoo.com