Ethmoidal mucocoele

Case contributed by Dr Laughlin Dawes


headaches and a long history of progressive spastic paraparesis

Patient Data

Age: 55
Gender: Male

An incidental finding on MR of brain and spine was a lesion in the region of the cribriform plate which was of high signal on T2 and FLAIR, and intermediate signal on T1.

Case Discussion

The appearance is typical of a small mucocoele. The differential diagnosis includes encephalocoele. There appears to be a bony plate between the lesion and adjacent frontal lobe, making encephalocoele less likely.

Mucocoeles are due to blockage of a sinus ostium and filling of the sinus with mucus, which acts as a slow-growing mass lesion. Posterior ethmoidal mucocoeles may cause pressure effects on the optic nerve. Frontal or anterior ethmoidal mucocoeles may expand into the orbit to cause proptosis. Infection of a mucocoele is a surgical emergency as rapid spread of sepsis may occur.

CT is most useful for diagnosis, as the characteristic sinus expansion and bone thinning is demonstrated. Mucocoeles are often of high signal on T1 due to the high protein content.

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Case information

rID: 7943
Published: 24th Dec 2009
Last edited: 6th Nov 2015
System: Head & Neck
Inclusion in quiz mode: Included

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