# An Unusual Skull With Bilateral Multiple Bony Lesions on the Parietal and Frontal Bones of the Superior Surface of the Calvaria: A Case Report

## TL;DR

This case report describes an unusual skull with multiple bony lesions on the top of the skull, highlighting the need for careful diagnosis.

## Contribution

The novelty lies in presenting a rare case of multiple calvarial lesions with detailed imaging and diagnostic considerations.

## Key findings

- Multiple flat osteosclerotic lesions were found on the outer table of the skull.
- Lesions varied in shape and were clustered on the parietal eminences and frontal bone.
- The largest lesion measured 0.98x10.32 mm with no involvement of the inner table or diploic space.

## Abstract

Calvarial lesions are often asymptomatic and may be discovered incidentally, such as during osteology class. This report describes a unique case of multiple calvarial lesions in an adult skull, emphasizing diagnostic considerations. Small bony lesions were noted on the superior and lateral calvarial surfaces bilaterally in a male skull. CT imaging revealed multiple flat osteosclerotic lesions predominantly on the outer table of the skull, with no involvement of the inner table or diploic space. These smooth lesions were clustered on the parietal eminences and included discrete lesions on the frontal bone, varying in shape from circular to ovoid with irregular margins. The largest lesion measured 0.98x10.32 mm. While benign conditions like osteomas or exostoses are common, differential diagnoses such as fibrous dysplasia and metastatic lesions should also be considered. This case underscores the importance of thorough imaging and clinical evaluation for accurate diagnosis and management of calvarial lesions.