Introduction: Temporal arteritis is the most common systemic vasculitis of the elderly. A definitive diagnosis is obtained on temporal artery biopsy examination (TAB). However, 30% of TAB yields false negative results. In such cases, diagnosis relies on clinical presentation and exclusion of alternative diagnosis. Conversely, false positive TAB are uncommon.
Case reports: We report two patients who presented with headache, scalp tenderness and increased acute phase reactants, suggesting temporal arteritis, but which turned out to reveal a skull metastase. Temporal artery biopsy performed in one case demonstrated arterial wall inflammation.
Conclusion: Clinicians must be aware that a skull lesion can mimick temporal arteritis.