Intradiploic epidermoid cysts

We studied 37 intradiploic epidermoid cysts, reviewing typical and atypical radiological features and the differential diagnosis. The most common clinical feature was a long standing lump in the scalp, occurring in 25 patients (67.7%). Plain films were the most cost-effective radiological technique in diagnosis. The typical finding was a well-defined lytic lesion with sclerotic border, seen in 29 cases (78%). Atypical lesions were those larger than 5 cm and/or with an ill-defined edge, being observed in 8 cases (22%). CT and MRI were the best methods for assessing atypical ones. In all cases with typical radiological findings a preoperative diagnosis of intradiploic epidermoid cyst was suggested.