• Alessandro Prior, Pasquale Anania, Mattia Pacetti, Francesca Secci, Marcello Ravegnani, Marco Pavanello, Gianluca Piatelli, Armando Cama, and Alessandro Consales.
• Division of Neurosurgery, IRCCS Istituto Giannina Gaslini, Genoa, Italy; Neurosurgery Unit, Ospedale Policlinico "San Martino", Genoa, and University of Turin, Turin, Italy.
• World Neurosurg. 2018 Dec 1; 120: 119-124.

BackgroundDermoid and epidermoid cysts are among the most frequent lesions of the scalp in the pediatric population. Optimal management of a suspected dermoid or epidermoid cyst in children is debated: Some authors advocate conservative management on the basis of the benign histology of these entities, while others prefer surgical excision.ObjectiveOur objective is to demonstrate that excision of dermoid and epidermoid cysts is a safe procedure and that early surgery is effective in preventing potential complications related to cyst growth.MethodsWe retrospectively collected data on patients who underwent surgery for excision of proven dermoid or epidermoid cysts between January 2006 and October 2017.ResultsIn 234 patients, 237 cysts were excised. Mean age at presentation was 26.99 ± 32.7 months; 48.7% of patients were operated on between 1 and 3 years of age, and 32.9% were younger than 1 year of age. Cysts were more frequently located in the frontal bone than in occipital and supraorbital regions. In 36.28% of cases there was no significant cranial impingement, while 21.94% of the cysts eroded through a partial thickness of the cranium, 12.23% were in the full thickness of the skull, and 0.84% had epidural extension. We identified 22 intradiploic cysts. Statistical analysis demonstrated significant association between frontal and pterional localization and bone erosion. Neither major complications nor cyst recurrence were observed.ConclusionsExcision of dermoid and epidermoid cysts is a safe procedure for neurosurgeons dealing with this disease, even in young patients. Early resection is recommended due to the potential adverse effects that may occur if these cysts are left untreated.Copyright © 2018 Elsevier Inc. All rights reserved.

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