Paget's disease with tumefactive soft tissue extension mimicking a chronic subdural hematoma.

Paget's disease, the leading cause of skull sclerosis, is often under-diagnosed on imaging with tumefactive soft issue extension being mistaken for other intracranial findings. A 71-year-old female with past medical history of hypertension, chronic obstructive pulmonary disease, transient ischemic attack, 7 pack year smoke history, and alcohol abuse experienced an episode of bilateral upper extremity weakness, left arm numbness, left hand clumsiness, and word deficits that resolved within 20 minutes. Head computed tomography showed a right convexity mass measuring 6 mm with slight mass effect on the right cerebral hemisphere but no midline shift.