Lump on the Back of Head - Pediatric Oncall

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Question
My 4 year old daughter developed a lump on the back of her head. There is no redness or head or opening, not painful. Has been as large as a golfball and can change size daily. Her behaviour changes when the lump is large. Nothing so in her blood test. Has had an X ray and a CT scan, no pressure or fluid on her brain. Is now waiting for a bone scan to rule out osteomyelitis, but we may have to wait upto 2 months. Can you give me anymore information and should we consider going private as we have family Bupa cover. Should we insist on treatment happening sooner. We first found the lump 5 weeks ago. At present the lump is there, but small. Thank you for any information you can give us.
Answer
A lump on the head that changes size needs to be investigated. Since the CT scan and the X ray is normal, it seems unlikely to be a cranial lesion or even a bone lesion. Is the lump soft or hard? Is it painful? If the lump is soft and non painful and not punching into the bone, it looks like a soft tissue swelling like a dermoid cyst or even a lipoma (fat tissue swelling). If there is a punched lesion in the bone, a condition such as eosinophilic granuloma should be ruled out. If the lump is painful, you need to get it investigated urgently. What would be most diagnostic would be to take a skin biopsy of the lump to come to the correct diagnosis. Back to All Questions

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