[Biometric studies of the occipital bone in the findings of Vértesszöllös].
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The authors describe a patient with a giant occipital intradiploic epidermoid cyst with compression of the torcular and other posterior fossa structures.
Tumours and tumour-like processes of the cranial bones do not occur very frequently; 2.5 per cent of all bone tumours are found in the calotte. On the other hand, the pre-operative and operative error possibilities regarding these processes are considerable, leaving multiple bone metastases out of consideration. The situation is complicated by many processes in the vicinity of the bone which affect or alterate the bone secondarily. On the basis of two better known tumours, the giant cell tumour and the aneurysmatic bone cyst, the diagnostic possibilities and difficulties are discussed in greater detail. The value of computer tomography mainly consists in the exact localisation in the bone and the surrounding tissues. Scintigraphy, too, can yield valuable information. Since in these processes as well as some other tumours no advantages can be derived from an irradiation therapy, but induced malignisations are even possible after several years, radical surgery is the only therapy of choice that is left. Considerable difficulties may arise in this connection due to narrow relations to vessels and blood paths. Finally, the problems of a prognostic statement is dealt with because histologic examinations, for instance in case of giant cell tumours, cannot yield precise information either with respect to dignity. Some authors, therefore, classify the latter as potentially malignant tumours.
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This case illustrates the classic presentation, investigation, and management of diploic epidermoid cysts. It is important to consider this condition in the differential diagnosis of a scalp mass that is deep, nonmobile, and in the frontal, parietal, and occipital regions. If suspected, skull radiographs will provide invaluable information, and if a diploic epidermoid cyst is present, they will direct further management.
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Three cases of a bony canal have been found in 100 adult cranial bases on the lower half of the clival surface. The possible content, nature and significance of this canal are discussed and the term 'inferior median clival canal' assigned to this variety.