Head and neck masses are a significant diagnostic challenge and differential diagnoses range from inflammatory, infectious, and neoplastic conditions. Timely, accurate evaluation is essential for optimal patient outcomes. This review highlights a systematic approach to diagnosing head and neck masses through comprehensive history, physical examination, and a variety of diagnostic tools. Imaging modalities such as computed tomography (CT), magnetic resonance imaging (MRI), and ultrasound are integral in diagnosis. Fine-needle aspiration (FNA) biopsy is a minimally invasive option for a preliminary diagnosis. However, in cases where it may be inconclusive or when extensive tissue sampling is needed to confirm a diagnosis, open tissue biopsy is considered. Collaboration among a multidisciplinary team (surgeons, radiologists, and pathologists) is vital in developing an effective individualized treatment plan. Early detection and accurate diagnosis of head and neck masses are critical for achieving favorable clinical outcomes.

Prostate cancer metastases involving the orbit and/or paranasal sinuses represent a rare oncological presentation. Patients can have a myriad of symptoms such as proptosis, periorbital swelling, blurry vision, rhinorrhea, epistaxis, anosmia, or others depending on the structures involved. The differential diagnosis of paranasal sinus masses on imaging studies is broad and can include inflammatory, congenital, or neoplastic masses; leading to the requirement of biopsy for definitive diagnosis. Tissue sample is usually obtained via an endoscopic approach. The prognosis of such a presentation is not well described in the literature, but it is usually guarded due to the advanced stage of the disease and generally a poorly differentiated primary tumor. Treatments usually aim to reduce the burden of disease and debulk the tumor mass for palliative purposes. We present a case of a 71-year-old male presenting with unilateral proptosis and periorbital swelling secondary to prostatic metastasis.