Ethmoid mucocele

Case contributed by Ammar Ashraf
Diagnosis certain

Presentation

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

Patient Data

Age: 55 years
Gender: Male
mri
This study is a stack
Axial FLAIR
brain
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Axial T2
brain
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Sagittal T2 3D
right orbit
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Axial T1
SPR orbits
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Axial T1 SPR
C+ orbits
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Coronal T1
C+ brain
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Axial T2
SPIR orbits
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Info

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
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Axial
non-contrast
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Axial C+ portal
venous phase
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Coronal C+ portal
venous phase
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Sagittal C+ portal
venous phase
This study is a stack
Axial non-contrast
bone window
This study is a stack
Coronal non-contrast
bone window
This study is a stack
Sagittal non-contrast
bone window
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Info

Well-defined expansile fluid density lesion in the right posterior ethmoid air cells with remodelling 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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