In this report we describe a 50-year-old patient with a progredient indolent frontal swelling that appeared to be a diffuse large B-cell lymphoma. Only a few cases of a lymphoma outgoing the frontal sinus are described in the literature. In our case the lymphoma manifested itself as an intra- and extracranial invasion and mimicked a Pott"s Puffy tumor (PPT), a potential complication of an acute frontal sinusitis or frontal trauma. A PPT manifests itself as a frontal swelling caused by the subperiosteal abscess in the frontal region. Our patient reported a progredient nasal obstruction and B-symptoms that developed in about four weeks. Before the first presentation, a cranial MRI with PPT suspect was already performed elsewhere. A diffuse large B-cell lymphoma was histological detected after a surgical sampling which we performed instantly. Appropriate chemotherapy was initiated as soon the histology was known. In conclusion we emphasize the importance of recognition of specific alarm symptoms to initiate proper diagnosis and prompt treatment.

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