OBJECTIVE: This study reports an unusual case of a rapidly growing frontal sinus osteoma with an initial suspicion of malignancy, treated with a craniofacial approach for tumor resection and reconstruction with bone cement and plates. Report: A 34-year-old woman presented with a frontal headache, sometimes associated with nasal obstruction. A CT scan of the paranasal sinuses showed a calcified tumor in the left frontal sinus measuring 1.5 cm. Six months after diagnosis, the health insurance company agreed to the surgery, and another CT scan was requested, revealing a total compromise of the frontal and nasal bones and left orbit by a calcified mass, which suggested a malignant lesion. The MRI showed no intracranial involvement. The surgery was performed with a bicoronal flap, removing almost all of the frontal bone, left orbit, and part of the nasal bones. A reconstruction of the superior orbit was performed with bone cement and plates. Histopathology excluded the suspicion of malignancy and determined a diagnosis of frontal osteoma. CONCLUSION: Osteoma is the most common benign tumor of the paranasal sinuses. It mainly affects the frontal sinus, with symptoms of headache and chronic sinusitis. Nevertheless, it commonly demonstrates slow growth. Surgery is only indicated in cases of significant symptoms, obstruction of ostial drainage, rapid growth, or high extension. There are various methods of access for removal, including an endonasal approach, and the choice is made case-by-case.
