Firouzifar Mohammadreza, Shirkhani Sahar, Pourkhosravi Hamed, Karimi Melika
Department of Otolaryngology-Head and Neck Surgery Amir-Alam Hospital, Tehran University of Medical Sciences Tehran Iran.
Clin Case Rep. 2025 Sep 15;13(9):e70887. doi: 10.1002/ccr3.70887. eCollection 2025 Sep.
Epidermoid cysts are rare lesions in the frontal sinus, often presenting with nonspecific symptoms such as headaches and localized swelling. These factors can complicate diagnosis and management. This report describes an epidermoid cyst that was initially suspected to be a malignant mass due to the erosion of the anterior wall and the sclerotic nature of the lateral wall, which had extended toward the orbit. This conclusion is supported by the observation that its pressure has pushed the eye downward, suggesting a primary origin in the frontal sinus rather than the orbit. We present a case of a 21-year-old woman who had a 2-year history of right periorbital swelling and intermittent headaches. Imaging studies revealed a lesion in the right frontal sinus, and surgical intervention resulted in the excision of the cyst. During surgery, after removing the bone shell, it was confirmed that the lesion was an epidermoid cyst, ruling out the initial suspicion of malignancy. Histopathological examination confirmed the diagnosis of an epidermoid cyst. This case underscores the importance of imaging studies in diagnosis and highlights the effectiveness of surgical intervention for managing symptomatic epidermoid cysts in the frontal sinus. We aim to investigate how much of the normal anatomy of the frontal sinus and periorbital structures may have been affected, and how symptoms were managed.
表皮样囊肿是额窦中的罕见病变，常表现为头痛和局部肿胀等非特异性症状。这些因素会使诊断和治疗复杂化。本报告描述了一例表皮样囊肿，因其前壁侵蚀和向眼眶延伸的外侧壁硬化性质，最初被怀疑为恶性肿块。其压迫眼球向下这一观察结果支持了该结论，提示其原发于额窦而非眼眶。我们报告一例21岁女性，有2年右侧眶周肿胀和间歇性头痛病史。影像学检查显示右侧额窦有一病变，手术干预切除了囊肿。手术中，去除骨壳后，证实该病变为表皮样囊肿，排除了最初对恶性肿瘤的怀疑。组织病理学检查确诊为表皮样囊肿。该病例强调了影像学检查在诊断中的重要性，并突出了手术干预治疗额窦有症状表皮样囊肿的有效性。我们旨在研究额窦和眶周结构的正常解剖结构受影响的程度以及症状的处理方式。
