Presentation
Right eye swelling for 4 months.
Patient Data
There is a large well-defined lesion in the right ethmoid air cells and right sphenoid sinus measuring approximately 4.5 x 4 x 3.7 cm in CC, AP and TR diameters. The lesion returns high signal intensity on T1WI and T2WI without fat saturation, diffusion restriction or contrast enhancement.
Laterally the lesion is protruding into the right orbital cavity compressing and displacing the medial rectus muscle, abutting the optic nerve, and causing anterior and lateral displacement of the right globe. No invasion of the eye globe is noted. No extension to the cranial fossa.
Medially, the lesion is abutting the nasal septum. Posteriorly, the lesion is reaching the right sphenoid sinuses. No surrounding infiltrative changes are noted.
There is another fluid intensity lesion at left middle concha likely retained mucus contents.
Case Discussion
The high signal on T1WI and T2WI is due to pretentious rich contents of the mucocele.