Skull lesions

Skull vault lesions are rare and represent 1–2% of all bone masses. They are commonly an incidental finding or may be discovered during staging work-up for other diseases. Different classification systems can be employed in order to categorize such lesions: primary (benign and malignant) or secondary as well as neoplastic and non-neoplastic (inflammatory and proliferative). For many of these lesions the clinical and radiological features are often non-specific making the diagnosis cumbersome. Rather than being defined clinical entities, they frequently form part of a spectrum of disease where ruling out an unfavourable progression is of paramount importance. Combining a basic knowledge of the epidemiology, clinical presentation, imaging findings, and histopathology is essential to differentiate these pathologies. The aim of this chapter is to define the important features of each lesion, to offer an overview of the investigations and treatment, and to provide guidance for the differential diagnosis based on imaging. Therefore, pathological entities with similar radiological appearances are grouped together.