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Differential Diagnosis for Movable Lesion on Back of Scalp in Newborn

  • Single most likely diagnosis
    • Caput succedaneum: This is a common condition in newborns, characterized by a soft, movable, and fluctuant swelling on the scalp, often caused by pressure exerted during delivery. It typically resolves on its own within a few days.
  • Other Likely diagnoses
    • Cephalohematoma: A collection of blood between the skull and its covering, often resulting from birth trauma. It is usually more firm and fixed than caput succedaneum but can be considered in the differential for a movable lesion if it is not fully developed or if there is a component of subgaleal hemorrhage.
    • Subgaleal hemorrhage: Although less common, this condition involves bleeding into the space between the skull and the scalp, which can cause a fluctuant and movable mass. It is more serious than caput succedaneum and cephalohematoma due to the potential for significant blood loss.
  • Do Not Miss (ddxs that may not be likely, but would be deadly if missed.)
    • Subperiosteal hematoma: While less likely, this condition involves bleeding between the periosteum and the bone and can be life-threatening if not recognized and managed properly. It might present with a more fixed mass but can have components that feel movable.
    • Leptomeningeal cyst: A rare condition where there is a defect in the skull and meninges, allowing cerebrospinal fluid to accumulate and form a cyst. It is crucial to identify this condition to prevent complications such as meningitis or further neurological damage.
  • Rare diagnoses
    • Dermoid cyst: A congenital anomaly that can present as a movable mass on the scalp. It is filled with desquamated skin and other tissue and may have a connection to the central nervous system, making its diagnosis and treatment critical.
    • Encephalocele: A rare congenital defect where part of the brain and its covering membranes protrude through an opening in the skull. It can present as a movable, cystic mass on the scalp and requires urgent medical attention to prevent infection and further neurological complications.

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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