Presentation
Slight proptosis in the right eye. Occasional double vision. Need to exclude thyroid eye disease or any underlying lesion.
Patient Data
Minor right proptosis. Bilateral frontal sinus mucoceles with the suggestion of bony erosion of the superior orbital walls.
Fluid in the ethmoid sinuses and bilateral maxillary sinus mucosal thickening.
Normal intracranial appearances.
Normal rectus muscles.
Expansile lesions in both frontal sinuses. On the right, this measures 3.6 cm, with bony destruction of the superior orbital wall measuring 2.3 cm. Further destruction measuring 3.2 cm of the floor of the anterior cranial fossa.
3.3 cm left-sided lesion with a 1.9 cm erosion in the left superior orbital wall. The anterior cranial fossa on the left is intact.
Extensive fluid in the ethmoidal sinuses.
Minor bilateral mucosal thickening in the maxillary sinuses. The sphenoid sinuses are normally aerated.
Case Discussion
Appearances keeping with bilateral frontal sinus mucoceles with bony erosion.
Proptosis or periorbital swelling can be the first presentation of this benign but locally aggressive condition.
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