Incidental Calvarial Abnormality Identified During Pediatric Airway Evaluation

A 5-year-old patient with no significant medical history was referred for airway evaluation, with plans to be seen by ENT. During full-volume review, the radiologist identified a unilateral parietal calvarial abnormality demonstrating marked thinning with areas of possible full-thickness osseous loss and indistinct inner and outer tables. These imaging features fall into a gray zone between developmental variation and a pathologic process. The radiologist noted that this case underscores the importance of maintaining a broad differential, recognizing the limitations of dental CBCT for calvarial assessment, and prioritizing appropriate referral and advanced imaging when findings are atypical or not confidently benign.