Objective: We present the case of a frontal sinus osteoma in a 71-year-old Japanese woman who presented with an approximately 2-year history of head dullness. Case report: CT showed a 45×39 mm radio dense mass extending from the left to the right frontal sinus. Under general anesthesia the mass was removed by endoscopic surgery. Although the tumor was large and extended into both frontal sinuses, the tumor was completely removed, without CSF leakage or orbital complications, by using a modified

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... Lothrop procedure. Conclusion: A unique osteoma of the frontal sinus is described. The challenges related to surgical treatment of this particular case and similar lesions are addressed. Figure 1: Preoperative CT scan shows a bone-density lesion in the right and left frontal sinuses. The bone is expanded, and the cortices are intact.