Frontal Sinus Epidermoid Cyst: A Rare Clinical Entity With Diagnostic Challenges and Surgical Considerations—A Case Report

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.