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Frontoethmoidal mucocele

Case contributed by Dr Mostafa El-Feky

Presentation

Left frontal swelling

Patient Data

Age: 65 years
Gender: Male
CT

Paranasal sinuses

Bilateral functional endoscopic sinus surgery (FESS) with bilateral middle turbinectomy, uncinatectomy and maxillary antrostomy.

Total opacification of the left frontal and ethmoid sinuses associated with multiple wide focal osseous dehiscences, notably in lamina paprychia/ medial orbital wall with intra-orbital extra-conal extension partially encroaching upon medial rectus and superior oblique muscles. Focal osseous dehiscences also noted at the left cribriform plate and the left lateral lamella as well as along the left anterior ethmoid artery canal. Mild secondary left proptosis.

Right maxillary antrum retention cyst measuring about 1.9 cm.

Few frothy secretions are seen in the left sphenoid sinus.

MRI

Paranasal sinuses

The left frontal and ethmoid sinuses are opacified and expanded with dehiscence of inferiomedial wall and extra-conal extension stretching the medial rectus and superior oblique and indenting the globe.

This opacity shows homogeneous signal: T1 hyper- and T2 intermediate.

No post-Gadolinium enhancement (verified by subtraction).

Right maxillary antrum retention cyst.

Case Discussion

MRI features are in keeping of frontoethmoidal mucoceles. They can be large resulting in proptosis. MRI was indicated to differentiate it from malignant sinonasal tumors. 

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Case information

rID: 82289
Published: 15th Oct 2020
Last edited: 15th Oct 2020
System: Head & Neck
Inclusion in quiz mode: Included

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