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A deceitful stroke, a hidden tumour. A 41-year-old woman with malignant left middle cerebral artery infarction underwent an immediate decompressive craniectomy, obtaining good recovery, both clinically and radiologically. However, approximately 6 months after a successful discharge, the patient returned with gradual memory deterioration, dysarthria and progressively worsening headaches. Subsequent CT and MRI of the brain revealed a solid malignancy located in the same region as the extensive infarction. Following this finding, she underwent surgical debulking of the tumour and follow-up radiotherapy, with good progression of symptoms and overall good outcome.