A 49-year-old woman with a history of head trauma

This is the case of a 49-year-old woman, who was hit on the head with a gymnasium weight 2 years previously. She presented with a 12-month history of an enlarging lump in the same area. The lump was large and smooth, non-tender, bony hard mass, with overlying alopecia. It was non-pulsatile with no bruits. The lesion was percussion dull and there was no regional lymphadenopathy. Computed tomography (CT) scan showed a non-enhancing area of diffuse sclerosis consistent with a healing fracture. A bone scan suggested fibrous dysplasia, sarcoma or Paget's disease. Surgical excision and histopathological examination revealed that the lesion was in fact an infiltrating meningioma, which was histologically benign. The patient subsequently underwent a more extensive craniotomy with dural replacement grafting and cranioplasty. The patient is now physically well enough to return to work.