Fronto-Orbital Osteoblastoma With Unilateral Exophthalmos: A Rare Presentation and Review of Diagnostic Challenges

Osteoblastoma is an uncommon benign bone tumor rarely involving the craniofacial skeleton. Manifestations in the fronto-orbital region are exceptionally rare. A 19-year-old man presented with persistent headache, nausea, vomiting, right eye pain, and longstanding right exophthalmos. Imaging revealed a heterogeneous enhancing lesion located in the right anterior cranial fossa-orbital apex junction causing pressure on the orbital roof. Differential diagnoses included fibrous dysplasia and meningioma. The tumor was resected via frontal craniotomy. Definitive diagnosis of osteoblastoma was achieved postoperatively through histopathological examination and IHC studies. Craniofacial osteoblastomas, especially in the fronto-orbital region, are exceptionally rare and may present radiological features similar to other bone pathologies. Accurate diagnosis hinges on histopathological evaluation. A multidisciplinary approach is pivotal for successful diagnosis and treatment of such challenging cases.