CLINICAL HISTORY.—A 2-year-old girl was referred to the Children's Hospital of Los Angeles because of a defect in the skull. The child had been well, but, because of head trauma, skull films had been obtained at which time the defect was detected (Figs 1 and 2).
On examination, the defect in the midline of the skull was palpable with normal growth of hair over the area, and no soft tissue mass was palpable. The child's development was normal and no neurologic abnormalities were detected. The liver and spleen were not enlarged, and there was no lymphadenopathy.
This developmental variant must be differentiated from reticuloendotheliosis, epidermoidoma, encephalocele, and dermal sinus. When large, they are easily palpable, but do not have an overlying soft tissue mass. Their location, in the lateral projection, is characteristic and should make their distinction from the previously mentioned abnormalities relatively simple.
Denouement and Discussion