Male, 32 years old, with neurofibromatosis and diffuse scalp neurofibroma status post resection and skin grafting two years ago, with new occipital swelling and intense pain. Redemonstrated is evidence of right parietal and occipital scalp surgery and grafting. The scalp soft tissues are scarred and mildly redundant, similar to prior. No definite evidence of any scalp tumor recurrence is seen, and no erosion of the underlying calvarium is evident. Incidentally noted is area of marked thinning of the left parietal bone. This finding is unchanged when compared to examinations dating back to 2011, and there is no definite masslike or enhancing lesion in the overlying scalp.Thickening of the optic chiasm, left side more than right, is unchanged. As before, this lesion does not enhance. No lesions of the intraorbital optic nerves are suspected on this nondedicated examination. Brain parenchymal morphology and signal characteristics are otherwise unremarkable. No pathologic intracranial enhancement is seen. No abnormal fluid collections are detected. The ventricles are normal in size and morphology.
1.Sequelae of prior scalp resection and skin grafting are redemonstrated without significant interval change. In particular, no evidence of any recurrent scalp tumor is seen.2.Presumed optic chiasm glioma shows no significant interval change as well. No other concerning intracranial findings are seen.3.Chronic thinning of the left parietal bone is incidentally noted. Given stability over many years and lack of any apparent aggressive lesion in this location, a congenital or developmental etiology is favored.