Introduction: Cholesterol granuloma (CG) can be found in several areas of the body. Maxillary sinus localization is considered rare.
Case report: A 37-year-old male presented with acute febrile sinusitis. Nasal endoscopy showed a nasal polyp at the middle meatus. Computed Tomography (CT scan) of the sinus showed complete opacity of the right maxillary sinus without calcification and partial opacification of frontal and ethmoidal sinuses. Functional endoscopic sinus approach was performed. Marsupialization of the cyst which a brownish fluid, which evoked the diagnosis of cholesterol granuloma.
Conclusion: The definite diagnosis is made by histology, although intra-operative finding could be suggestive. Complete excision is achievable by endoscopic approach.