Maxillary sinus pyogenic granuloma with orbital extension: a rare pediatric presentation mimicking malignancy.

We report the case of an 11-year-old girl who presented with 2 weeks of nonspecific facial pressure and pain and who was ultimately found to have a right maxillary sinus mass with orbital invasion. Initial imaging and clinical features raised concern for malignancy. However, following biopsy and surgical resection, final pathology revealed a pyogenic granuloma. This benign vascular lesion has rarely been described in the maxillary sinus and, to our knowledge, has not previously been reported to involve the orbit. This case underscores the importance of maintaining a broad differential diagnosis when evaluating pediatric sinonasal masses and highlights the diagnostic challenges posed by orbital involvement.