A 83 years old man was admitted to acute medical unit for mild asthma exacerbation. He also had atrial fibrillation and was on dabigatran. A mass on left upper chest wall was incidentally found. There were bruises over left posterolateral aspect of chest wall. Chest X-ray showed left pleural effusion. Diagnostic tap yielded blood-stained fluid. Computer tomography showed left lung herniation. Cardiothoracic surgery team unit was consulted. Reduction of lung herniation and patch repair of chest wall defect was done.

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Meningiomas are the most common central nervous system (CNS) tumors. Extracranial meningiomas are rare, constituting 2% of all meningiomas. We describe a case of Lopez type III meningioma of the scalp in a 72-year-old gentleman who had a long-standing giant scalp mass and presented with recent mild left-sided limb weakness and numbness. Magnetic resonance imaging (MRI) of the skull demonstrated a right frontoparietal tumor extending through the skull into the scalp. Tumor excision revealed World Health Organization (WHO) grade 1 meningioma. Clinicians should correlate a cutaneous skull mass and new onset of neurological symptoms. Cutaneous meningioma is an important differential diagnosis.

Introduction: Brain abscess and subdural empyema are the most common surgically treated intracranial infections. Involvement of all layers from scalp, epidural and subdural region in brain abscess has not been reported. The clinical significance of the anatomy of emissary veins, sinuses and brain parenchyma is illustrated. Case presentation: A 25-year-old man with a history of sinusitis presented with headache, confusion, fever and a left frontal scalp swelling. Computed tomography (CT) scan of brain revealed sinusitis and abscesses involving scalp, epidural, subdural regions and brain parenchyma. The patient underwent surgical drainage and antibiotic treatment. No complication occurred and the patient recovered with no neurological deficit. Conclusion: Brain abscess is a potentially fatal complication of sinusitis. The presentation of scalp abscess could be a sign of deep infection. Clinicians should have a high degree of awareness in order to prevent neurological complications. Prompt diagnosis and treatment is emphasized.