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NEJ Cases Orthopaedic A old man presented with frontal headache

A old man presented with frontal headache

imageimageA 63-year-old man presented with a long-standing history of sinusitis and 3 weeks of frontal headache. The physical examination was unremarkable. The alkaline phosphatase level was elevated at 434 IU per liter (upper limit of the normal range, 129). The serum calcium level was within normal limits

 

Comment about his Radiographic findings?

What are the  DDx ?

What is the Rx for headache ?

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