R. NICKBRYANMDS. JAMESZINREICHMD
A 41-YEAR-OLD MAN presented with right temporal fullness that had been gradually enlarging over 16 years. There was no history of trauma, pain, headache, drainage, dizziness, hearing loss, numbness, or diplopia. Physical examination of the patient's ear, nose, throat, head, and neck revealed a 6×8-cm moderately firm, circumscribed mass of limited mobility in the right temporal region. There were no overlying skin abnormalities, neck masses, or neurologic deficits.
The patient was taken to the operating room for excision of the mass. The preoperative diagnosis was lipoma. After a 4-cm right temporal incision was made, dissection revealed a multilobulated mass deep to the temporalis muscle (Figure 1). Dissection proceeded in a posterior to anterior fashion until the mass was found to extend through a bony defect of the coronal suture at the level of the orbital apex. The extracranial portion was resected and the incision was closed.
Posey LA, Sterman BA. Quiz Case 2. Arch Otolaryngol Head Neck Surg. 1999;125(8):913. doi: