Ethmoid mucocele

Case contributed by Dr Ammar Ashraf

Presentation

Headache, decreased right eye vision and painful ocular movements for 1 month.

Patient Data

Age: 55 years
Gender: Male
MRI

Findings: Expansile cystic lesion measuring 26 x 26 x 14 mm noted in the right middle / posterior ethmoid sinuses. The lesion displays increased signal intensity on T1 SPR, T2 and FLAIR sequences and does not show any post contrast enhancement. It is causing expansile thinning of the lamina papyracea and mild lateral displacement of the medial rectus muscle. The optic nerves, both eye globes and brain are normal. Impression: Expansile cystic lesion in the right ethmoid sinuses, likely representing an ethmoid mucocele

CT

Well-defined expansile fluid density lesion in the right posterior ethmoid air cells with remodeling changes in the surrounding bones. Mild mucosal thickening of bilateral maxillary, sphenoid and left frontal sinuses and left ethmoid air cells. Partially obliterated right osteomeatal complex.

Case Discussion

Procedure: Functional endoscopic sinus surgery (FESS).

Diagnosis: Mucocele

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