{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,7]],"date-time":"2026-10-07T13:54:31Z","timestamp":1791381271969,"version":"4.3.3"},"reference-count":17,"publisher":"BMJ","issue":"10","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Rep"],"accepted":{"date-parts":[[2026,9,7]]},"published-print":{"date-parts":[[2026,10]]},"abstract":"<jats:p>Pott\u2019s puffy tumour (PPT) is a rare complication of frontal sinusitis involving subperiosteal abscess and frontal bone osteomyelitis, often leading to serious intracranial sequelae. We report a case of a man in his 50s who presented with progressive, painless forehead swelling despite multiple antibiotic courses. Imaging confirmed bilateral subperiosteal collections and a right-sided epidural empyema. Initial management included broad-spectrum antibiotics, endoscopic sinus surgery and external drainage. Due to persistent collections, a second-stage osteoplastic approach was performed, resulting in complete resolution. Cultures were sterile, possibly due to early antibiotic administration. The patient completed 6\u2009weeks of parenteral antibiotics and remained symptom-free at the 8-month follow-up. This case highlights the importance of early recognition, imaging and surgical management of PPT to prevent complications. An individualised, combined endoscopic and external approach may be essential in advanced presentations.<\/jats:p>","DOI":"10.1136\/bcr-2025-267764","type":"journal-article","created":{"date-parts":[[2026,10,7]],"date-time":"2026-10-07T13:15:18Z","timestamp":1791378918000},"page":"e267764","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["Silent danger behind the forehead: Pott\u2019s puffy tumour presenting without systemic symptoms"],"prefix":"10.1136","volume":"19","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9462-2251","authenticated-orcid":false,"given":"Ana Rita","family":"Rodrigues","sequence":"first","affiliation":[{"name":"Otorrinolaringologia, Unidade Local de Sa\u00fade de Matosinhos EPE, Senhora da Hora, Portugal"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Delfim","family":"Duarte","sequence":"additional","affiliation":[{"name":"Otorrinolaringologia, Unidade Local de Sa\u00fade de Matosinhos EPE, Senhora da Hora, Portugal"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1726-5991","authenticated-orcid":false,"given":"Nuno","family":"Oliveira","sequence":"additional","affiliation":[{"name":"Otorrinolaringologia, Unidade Local de Sa\u00fade de Matosinhos EPE, Senhora da Hora, Portugal"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2026,10,7]]},"reference":[{"key":"2026100706151204000_19.10.e267764.1","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjoto.2022.103529"},{"key":"2026100706151204000_19.10.e267764.2","doi-asserted-by":"crossref","DOI":"10.3390\/jcm13216428","article-title":"Pott\u2019s Puffy Tumor in Young Age: A Systematic Review and Our Experience","volume":"13","author":"Daloiso","year":"2024","journal-title":"J Clin Med"},{"key":"2026100706151204000_19.10.e267764.3","doi-asserted-by":"crossref","first-page":"8","DOI":"10.1007\/s00106-021-01134-w","article-title":"Pott\u2019s puffy tumor: a need for interdisciplinary diagnosis and treatment","volume":"70","author":"K\u00fchn","year":"2022","journal-title":"HNO"},{"key":"2026100706151204000_19.10.e267764.4","doi-asserted-by":"publisher","DOI":"10.1002\/lary.27757"},{"key":"2026100706151204000_19.10.e267764.5","doi-asserted-by":"crossref","DOI":"10.1093\/jscr\/rjz099","article-title":"Potts puffy tumour: a rare but important diagnosis","volume":"2019","author":"Hasan","year":"2019","journal-title":"J Surg Case Rep"},{"key":"2026100706151204000_19.10.e267764.6","doi-asserted-by":"crossref","DOI":"10.1002\/ccr3.7815","article-title":"Pott\u2019s puffy tumor: A case report","volume":"11","author":"Vadiee","year":"2023","journal-title":"Clin Case Rep"},{"key":"2026100706151204000_19.10.e267764.7","first-page":"143","article-title":"The Pott puffy tumor revisited: neurosurgical implications of this unforgotten entity. 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