Challenging Craniotomy of Large Frontal Sinus Mucocele With Intracranial Extension

A 45-year-old man presented with a swollen left eye for two years, and it has been worsening in the last few months. A gradual decrease in vision in the right eye accompanies this complaint. The head CT scan examination showed a hyperdense mass (51 HU), extra-axial, thick-walled, well-defined, regular edges, and non-calcified, which increased particularly on the left frontal and pressing on the left lateral ventricle. A craniotomy was performed for mucocele evacuation. This case highlights the urgency of early detection before the erosion of the surrounding bone and intracranial invasion. Early craniotomy surgery is advantageous and is still challenging for this case.