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Ethmoid mucocele with proptosis

Case contributed by Ammar Haouimi
Diagnosis almost certain

Presentation

Right exophthalmos. History of paranasal sinus surgery.

Patient Data

Age: 50 years
Gender: Male

The MRI sequences demonstrate a right ethmoidal mucocele of intermediate to high signal intensity on T1WI, high signal intensity on T2WI with areas of low signal (protein rich content) and peripheral enhancement following IV contrast. There is an extension to the ipsilateral nasal fossa as well as an expansile thinning of the lamina papyracea with compression of the right globe which is displaced laterally (non-axial proptosis).

Mucosal thickening of both maxillary, sphenoid and frontal sinuses with a filling of the left ethmoid cells. 

Postoperative status of the maxillary sinuses.

Case Discussion

Ethmoidal mucoceles are the second most common type after frontal mucoceles and usually due to an obstruction of the sinus ostium (e.g. inflammation, secretions, or mass lesion). It can cause compression of the orbit with proptosis, as in this case.

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