Primary trans-calvarial lymphoma: A rare entity

Abstract

Primary trans-calvarial lymphoma with both intracranial and extracranial extension is a scarcely described entity in published literature. Most often, these lesions are misdiagnosed as hematomas or meningiomas. We hereby report an interesting case of a 60-year-old female presenting with a large scalp mass. The diagnosis at the time of referral was an organized scalp hematoma. Magnetic resonance imaging of the brain revealed a large isointense enhancing mass lesion with transcalvarial extension involving the scalp as well as the meninges. Histopathology and immunohistochemistry confirmed a diagnosis of diffuse large B-cell lymphoma. Our case was unique in that the presentation was with a large scalp lesion with a reasonable meningeal component and invasion of the superior sagittal sinus without any associated focal neurological deficit.