E-ISSN: 1019-5157
ISSN: 2651-5024
Research
Clinical and Pathological Profile of Calvarial Masses: A Retrospective Analysis
Ali Maksut Aykut✉ ,
MUSTAFA EMRAH KAYA ,
Mustafa Aras ,
Yurdal Serarslan ,
Boran Urfalı
Neurosurgery, Mustafa Kemal University; Neurosurgery, On Dokuz Mayıs University; Neurosurgery, Ordu University Medical Faculty
DOI: 10.5137/1019-5149.JTN.52033-26.3
Accepted: 26/09/2026
Article in Press
Corresponding Author:
Ali Maksut Aykut (dralimaksut@gmail.com)
Abstract
Aim
Calvarial masses encompass a broad spectrum of benign and malignant neoplasms. This study describes their clinical, radiological, and pathological features, evaluates preoperative diagnostic accuracy, and proposes a practical management algorithm.
Material and Methods
A total of 115 patients with calvarial masses were retrospectively reviewed, of whom 26 met the preestablished inclusion criteria. Demographic, clinical, radiological, surgical, and histopathological data were systematically recorded. Radiology–pathology concordance was assessed using the Cohen kappa coefficient. Diagnostic accuracy was evaluated using a binary classification framework, with histopathology as the reference standard. Sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) were calculated. Categorical variables were compared using Fisher’s exact test with Bonferroni correction.
Results
Among 26 patients, comprising 14 females (53.8%) and 12 males (46.2%), the mean age was 19.1±14.8 years (range, 1–54 years). The mean lesion size was 3.2±1.8 cm. The most common diagnosis was eosinophilic granuloma (n=8, 30.8%), followed by fibrous dysplasia (n=5, 19.2%) and epidermoid cysts (n=3, 11.5%). Preoperative radiological and postoperative histopathological diagnoses demonstrated strong agreement (κ=0.78; 95% confidence interval [CI]: 0.62–0.94; p<0.001). Radiological diagnosis exhibited a sensitivity of 88.5% (95% CI: 76.2–95.3%), specificity of 91.2% (95% CI: 79.8–97.1%), PPV of 89.7%, and NPV of 90.3%. Mean follow-up was 38.4±22.1 months (range, 6–108 months). The complication rate was 3.8% (n=1, Clavien–Dindo Grade I), and recurrence occurred in two patients (7.7%), both with eosinophilic granuloma.
Conclusion
Calvarial masses predominantly affect young patients and exhibit significant pathological diversity. In such patients, modern imaging techniques can provide high preoperative diagnostic accuracy. A systematic surgical approach, including complete resection and appropriate reconstruction, may achieve lower complication rates and favorable cosmetic outcomes. The proposed treatment algorithm may provide a practical framework for the management of calvarial masses.
Calvarial masses encompass a broad spectrum of benign and malignant neoplasms. This study describes their clinical, radiological, and pathological features, evaluates preoperative diagnostic accuracy, and proposes a practical management algorithm.
Material and Methods
A total of 115 patients with calvarial masses were retrospectively reviewed, of whom 26 met the preestablished inclusion criteria. Demographic, clinical, radiological, surgical, and histopathological data were systematically recorded. Radiology–pathology concordance was assessed using the Cohen kappa coefficient. Diagnostic accuracy was evaluated using a binary classification framework, with histopathology as the reference standard. Sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) were calculated. Categorical variables were compared using Fisher’s exact test with Bonferroni correction.
Results
Among 26 patients, comprising 14 females (53.8%) and 12 males (46.2%), the mean age was 19.1±14.8 years (range, 1–54 years). The mean lesion size was 3.2±1.8 cm. The most common diagnosis was eosinophilic granuloma (n=8, 30.8%), followed by fibrous dysplasia (n=5, 19.2%) and epidermoid cysts (n=3, 11.5%). Preoperative radiological and postoperative histopathological diagnoses demonstrated strong agreement (κ=0.78; 95% confidence interval [CI]: 0.62–0.94; p<0.001). Radiological diagnosis exhibited a sensitivity of 88.5% (95% CI: 76.2–95.3%), specificity of 91.2% (95% CI: 79.8–97.1%), PPV of 89.7%, and NPV of 90.3%. Mean follow-up was 38.4±22.1 months (range, 6–108 months). The complication rate was 3.8% (n=1, Clavien–Dindo Grade I), and recurrence occurred in two patients (7.7%), both with eosinophilic granuloma.
Conclusion
Calvarial masses predominantly affect young patients and exhibit significant pathological diversity. In such patients, modern imaging techniques can provide high preoperative diagnostic accuracy. A systematic surgical approach, including complete resection and appropriate reconstruction, may achieve lower complication rates and favorable cosmetic outcomes. The proposed treatment algorithm may provide a practical framework for the management of calvarial masses.
Keywords
Calvarial masses
eosinophilic granuloma
fibrous dysplasia
epidermoid cyst
diagnostic accuracy
neurosurgical treatment