Q: I have a bump in the middle of my forehead the size of a nickel and seems to be slightly growing. . . saw a plastic surgeon yesterday and we are going to watch it. He mentioned a hematoma. . . I haven’t had any head injuries. Is hematoma common with this type of immovable hard lump?
A: I do not have the advantage of actually looking at your forehead lump. So anything I would say is speculative and without the advantage of the plastic surgeon who has seen it.
However, without a specific history of any head trauma, the most likely diagnosis is an osteoma, a benign bony growth down at the bone surface. Sometimes they appear as a result of forehead trauma but many times they do not. They can develop from any bleeding that occurs underneath the periosteum which is a great stimulus for bone growth. They almost always are associated with a perforating blood vessel where it exits the bone. They are hard and very slow growing. They are like a small circular disk or small mountain sitting right on top of the forehead bone. They can be removed through an endoscopic technique if they get big enough to cause a noticeable forehead bump. This is done through small scalp incisions where they are chiseled off of the bone under direct vision of the endoscopic camera. If there is a prominent foreheasd wrinkle nearby, they can also be removed through an incision in the wrinkle.