Abstract

Background: Differentiation between traumatic injuries and pathological lesions continues to be one of the challenges in medico-legal practice, especially as intracranial tumours sometimes present features similar to the appearance of entrance or exit wounds caused by gunfire. These misunderstandings may completely change the medico-legal scenario of the case, wrongly implicating homicide or concealment of crime. Objective: The article attempts to analyse the forensic challenges involved when post-mortem ballistic trauma to the skull is mistaken with tumour-related anomalies, and to evaluate how Indian medico-legal systems, including the Bharatiya Sakshya Adhiniyam, 2023, address the evidentiary implications of such intersections. Methods: A search was carried out on PubMed, Scopus, Web of Science, ResearchGate and Google Scholar between 1997 and 2024. The review gradually deliberates the information recycled from ongoing scientific literature and landmark case reports, legal-medico tenets emanating from the Indian setting, integrating the contribution of forensic athology, forensic radiology and digital autopsy practices. Results:Results indicate that cranial tumours may radiologically or morphologically mimic a gunshot wound, posing a significant problem for the investigator. The integration of neuropathology and forensic reconstruction, together with a supraspecialistic expert testimony, is necessary for removing doubts and enabling forensic admissibility of the evidence. Conclusion: An interdisciplinary approach is necessary to prevent miscarriage of justice in suspected headshot deaths with occult neoplasms by combining forensic medicine and law. More use of scientific benchmarks, admissibility standards, and expert interpretation may protect fair trial rights in cases of such complexity. Key Messages: Cranial tumours can be mistaken for gunshot wounds, and this can carry grave medico-legal implications with miscarriages of justice involving false convictions or acquittals. To obtain precision, it is necessary to cooperate with several disciplines, including forensic pathology, radiology and digital autopsy. Definitional clarity, stringent evidentiary standards and empirical validation are critical to admissibility under Bharatiya Sakshya Adhiniyam, 2023, and call for a closer nexus between law and medicine to preclude unjust verdicts.

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