Learning objectives
Role of imaging in the diagnosis and follow-up ofpediatric cranio-facial lytic lesions with acranio facial lytic lesions pattern overview.
Case series with key diagnostic points highlighted in the discussion of each case.
Up to date patterns and differential diagnosis.
Background
Cranio-facial lytic lesions are a common topic in the daily practice of pediatric radiologists.
Diagnosis in children is often incidentally in asymptomatic patients who perform radiological or neuroradiological exam with other clinical questions.
Role of imaging in the diagnosis and follow-up of pediatric cranio-facial lytic lesionsis recognized as crucial for diagnosis,
follow up and correct management.
The detailed knowledge of the radiological semeiotic of the lesions andthe differential diagnosis related to patient’s age andclinical history are fundamental in making the radiologic diagnosis and for the...
Findings and procedure details
Case series
Case 1
Female: 9 years and 4 months.
Right parietal tumefaction,
not painful,
for about 15 days.
No trauma in anamnesis.
MRI without contrast already performed MR in another hospital.
Fig. 1
Neoplasmwith an inhomogeneously high signal in all sequences (FLAIR axial images,
and T1w,
coronal image T2w,
right parietal,
prominent in the inracranial soft tissues and in the intracranial side.
There is no signal alterations in the adjacent nervous tissue,
nor perilesional edema.
Imaging recommendation: CT to evaluate bone involvement.
Fig. 2...
Conclusion
Imaging plays an important role in the diagnostic investigation of patients presenting these lesions.
Imaging gol is to achive a diagnostic hypothesis combining all radiological findings with clinical information.
It is essential to answer the clinician to the following questions.
Identification of the site of the lesion
To formulate hypothesesbased on CT and MR features
Staging
Follow up (identify which exam is most appropriate)
Provide the necessary information to the surgical planning in case of malignant lesions
In some cases in which the lesions develop...
References
Demaerel P,
Van Gool S.
Paediatric neuroradiological aspects of Langerhans cell histiocytosis.
Neuroradiology 2008; 50:85-92.
Zhang L,
Jiang L,
Yuan H,
Liu Z,
Liu X.
AtlantoaxialLangerhanscellhistiocytosisradiographiccharacteristicsandcorrespondingprognosisanalysis. J Craniovertebr Junction Spine
2017 Jul-Sep;8(3):199-204.
doi: 10.4103/jcvjs.JCVJS_21_16.
Zaveri J,
La Q,
Yarmish G,
Neuman J.
More than just Langerhans cell histiocytosis: A radiologic review of histiocytic disorders.Radiographics.2014;34:2008–24
K.M.
Chevallier,R.H.
Wiggins,N.A.
QuinnandR.K.
Gurgel.
Differentiating Pediatric Rhabdomyosarcoma and Langerhans Cell Histiocytosis of the Temporal Bone by Imaging Appearance.American Journal of NeuroradiologyJune 2016,37(6)1185-1189.
Attanayake D,
Dias B.
Removalof alowclivalchordomain ateenagerbydorsolateralsuboccipitaltranscondylarapproach.
Asian...