Total Removal of a Giant Frontal Sinus Osteoma with Orbital Extension - A Case Report

THE RATIONALE: Osteomas are benign tumours that are usually asymptomatic. However, giant osteomas can lead to severe complications. We report here the management of a giant frontal sinus osteoma with orbital extension. PATIENT CONCERNS: We present the case of a 17-year-old patient presenting with rapidly progressive isolated right exophthalmos. DIAGNOSIS: A cerebral computed tomography scan was performed and showed a giant osteoma of the right frontal sinus extending to the orbit and massively eroding the anterior wall of the frontal sinus. TREATMENT AND OUTCOMES: The patient underwent surgery and a complete removal of the osteoma was accomplished via an open approach, but without performing a bone flap. No recurrence was observed after 2 years of follow-up. TAKE-AWAY LESSONS: Although rare, giant frontal osteomas can cause severe functional impairment due to their proximity to noble structures. Therefore, open approach remains the mainstay of therapy.