We report the case of a fifty years old patient with past medical history of cerebral palsy referred from ophthalmology department for right supra orbital swelling involving the eyelid. The beginning of signs is about four months by the onset of a sub cutaneous mass at the eyelid; he consulted at the ophthalmology department where after clinical examination a brain computed tomography (CT) scan was performed before his reference to the Neurosurgery Department. At the admission in our department the physical examination found a cachectic patient, complaining with fever in the evening and presenting a right supra orbital mass (Figure 1); the mass is non inflammatory, soft and painless. The brain CT scan objectified an osteolytic lesion of the orbital roof extended to frontal bone associated to an epidural lesion (Figure 2). We operated the patient under general anesthesia, we performed a skin incision through the right eyebrow; after the dissection of the subcutaneous tissues, we discovered and evacuated thick pus under the eyelid. We also discover an osteolytic lesion at the orbital roof extended to the frontal bone (Figure 3). We performed a biopsy of the bone lesion and the histological examination objectified a caseo follicular tuberculosis. The immediate post operative outcome was favorable with the disappearance of the collection. The patient was exited from the hospital 2 weeks after with a reference letter to infectious diseases department for anti tuberculosis treatment. The patient received the anti tuberculosis treatment for twelve months according to the national program. The control brain CT scan was performed after the completion of the treatment and there was no recurrence of the collection (Figure 4).