Frontal sinus osteoma associated with cerebral abscess formation: A case report

BACKGROUND Osteomas of the paranasal sinuses rarely lead to intracranial manifestation s. We present an unusual case of a frontal sinus osteoma leading to intrace rebral abscess formation. CASE DESCRIPTION A 51-year-old Hispanic man presented with increasing frontal headaches, new onset seizure, lethargy, global dysphasia, and unilateral hemiparesis. CSF studies demonstrated mild pleocytosis. Neuroradiological studies revealed an opacity filling the left frontal sinus, as well as a ring-enhancing mass with surrounding edema in the left frontal lobe. The patient was surgicall y treated with a left frontal osteoplastic craniotomy and removal of the ab scess and bony mass. Intraoperative cultures were positive for Streptococcu s pneumoniae. Pathology revealed bony tumor consistent with osteoma. The pa tient's neurological status improved to baseline after surgery. CONCLUSION The frontal sinus osteoma was associated with rapid development of a fronta l lobe abscess, requiring emergent surgical debridement. Although rare, int racerebral manifestations should be considered and expected as a cause of n ew neurological deficits in the presence of pfaranasal sinus osteoma. (C) 2 001 by Elsevier Science Inc.