Minerva

doi:10.1136/bmj.326.7380.112

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The small print may be accurate, but headlines are sometimes completely off the wall. A fine example of this is highlighted in the Oncologist (2002;7:475-6). A paper in the New England Journal of Medicine comparing “watchful waiting” for prostate cancer with radical prostatectomy grabbed the news last September. TheNew York Times proclaimed “prostate cancer surgery found to cut death risk”; the Boston Globe trumpeted “Two studies find no advantage to prostate surgery.” Neither was correct.

A 55 year old man presented with a scalp lesion. The initial diagnosis was a sebaceous cyst, and excision under local anaesthetic was planned, but the large size of the mass and the finding of bony fixation raised doubts. Cranial magnetic resonance imaging showed a giant intracranial parasagittal frontal tumour eroding through the top of the skull. The lesion was excised via a bilateral frontal craniotomy. Histological examination was consistent with meningioma, an entity known to cause bony erosion of the skull.

S J Griffiths, specialist registrar, G Wabwire, senior house surgeon, R M Redfern, consultant, N Powell, consultant neuroradiologist, department of neurosurgery, Morriston Hospital, Swansea SA6 6NL, D H Evans, general …