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Introduction: We described a rare clinical case of osteoma associated with homolateral radicular cyst of the maxillary sinus. Observation: Imaging showed two different lesions in the right maxillary sinus. We performed a combined surgical approach to completely remove the lesions and used a plasma rich in growth factors membrane to repair dental roots. No relapse after a 2 years follow-up was observed. Commentaries: The simultaneous presence of two large lesions, a 23,7 mm osteoma and a 33,7 mm radicular cyst in the same maxillary sinus, has been rarely described in the literature. Although nasal endoscopy and imaging are mandatory to assess the diagnosis, the definitive diagnosis was obtained after histopathologic examination. A combined surgical approach allowed a complete removal of both lesions, ensuring, at same time, an optimal surgical field. Plasma rich in growth factors membrane due to its cohesive properties was particularly useful in improving bone neoformation and periodontal regeneration. Conclusion: Diagnostic assessment of maxillary lesions requires nasal endoscopy, imaging and histopathological examination. If these lesions are symptomatic, they should be completely removed and minimally invasive surgery is indicated. Plasma rich in growth factors membrane ensures a good postoperative recovery. [ABSTRACT FROM AUTHOR]