Reliability of plain X-ray and computed tomography in diagnosis of invasive tumors of the scalp

Summary

The reliability of plain X-ray and computed tomography (CT) in the diagnosis of a penetrating tumor of the scalp to the calvarium was examined on the basis of the histopathologic reports following surgery. The correlation of other tumor characteristics, such as size, ulceration, duration and previous excisions or irradiation to the skull, with calvarial invasion was also studied. Of the 29 scalp tumors suspected clinically of invasion, four were proven histopathologically as penetrating to the bone. Only two of the four tumors diagnosed by plain X-ray of the skull as penetrating to the bone, and two of the six so diagnosed by CT, were histopathologically substantiated. No statistical correlation was found between the radiologic reports and the histopathology relating to the diagnosis of calvarial invasion by scalp tumor. The other tumor characteristics also did not correlate statistically with invasion. We conclude that the radiologic reports of plain X-ray and CT concerning penetration to the calvarium by scalp tumor are not reliable. In addition, there are no other tumor characteristics that correlate with histopathological penetration.