A Mysterious Case of Giant Scalp Devil's Horn with Intracranial Extension Removed by Surgical Excision.
M S A Siddique, M S Hossain, M K Hossen et al.
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Case in brief
A 60-year-old male presented with altered consciousness, chronic headaches, blurred vision, and scalp swelling. Imaging revealed a giant cutaneous horn in the scalp with underlying bony erosion and intracranial extension. Surgical excision involved removing the outer lesion, followed by craniotomy and decompression. The central part of the lesion was avascular and excised, leading to successful wound closure with a scalp rotation flap.
What made this case unusual
The case is notable for the giant size of the cutaneous horn and its rare intracranial extension, which is uncommon for such lesions.
Diagnostic / clinical pearl
Clinicians should consider the possibility of intracranial extension in patients with large cutaneous horns presenting with neurological symptoms.
Why it matters
This case highlights the importance of thorough imaging and surgical planning in managing atypical presentations of cutaneous lesions.