Malignant meningioma is an uncommon neoplasm of the central nervous system that rarely presents as an extracranial soft tissue mass. These malignancies may or may not be associated with intracranial lesions. In primary extracranial malignant meningioma, the tumor may arise from ectopic nests of arachnoid cells that follow cranial nerve pathways without involvement of bony structures. 1 In the case of intracranial malignant meningioma, the subcutaneous soft tissue mass extends directly from an underlying osteolytic skull lesion and intracranial tumor.2 Subfascial, or frontalis-associated, lipomas of the forehead were first described in Europe 3 and more recently in the American dermatologic literature.4 The differential diagnosis includes epidermoid cyst, pilar cyst, and, occasionally, dermoid cyst. We observed an intracranial malignant meningioma that bore a striking resemblance to a subfascial lipoma.