Primary sclerosing fibroinflammatory pseudotumor of the maxillary sinus misdiagnosed as migraine: A case report

Abstract

The head and neck region is a complex anatomical area where overlapping structures and nonspecific symptoms often make accurate diagnosis challenging. Facial pain, in particular, is a common yet ambiguous symptom frequently attributed to prevalent conditions like migraine, which can delay recognition of less common but clinically significant diseases. One such condition is Primary Sclerosing Fibroinflammatory Pseudotumor—a rare, benign lesion that can mimic malignancy both clinically and radiologically.We present the case of an 18-year-old female with chronic facial pain and globe displacement, misdiagnosed as migraine for four years. Imaging revealed a mass in the maxillary sinus with bone erosion and orbital involvement. A core needle biopsy was inconclusive, and definitive diagnosis was achieved only after surgical excision. Histopathological and immunohistochemical analysis confirmed Primary Sclerosing Fibroinflammatory Pseudotumor. The patient experienced substantial clinical improvement following combined surgical and corticosteroid therapy. This case highlights the importance of including rare pathologies in the differential diagnosis of maxillofacial masses and demonstrates the value of thorough investigation when symptoms persist despite standard treatment.