Presentation
Right cheek soft tissue mass for characterization.
Patient Data
Opacification of the right maxillary sinus with sclerosis of the right maxillary bone.
Well-defined expansile mass affecting the right maxillary sinus with remodeling and erosion of the anterior, medial and posterior walls. It has slight heterogeneous high T2 signal, low T1 and demonstrates thin, linear peripheral enhancement. Right maxillary infundibulum is obstructed by enhancing mucosa. Surrounding fat planes are well preserved. No suspicious lymph nodes. Loss of normal right maxillary marrow signal.
Right maxillary sinus is expanded with erosion of the anterior and posterior walls. Right maxilla is diffusely sclerotic when compared to the left suggesting chronic inflammation. Post and premaxillary fat planes have been maintained. Within the right maxillary sinus is an air-fluid level from interval drainage since MRI. No appreciable enhancing soft tissue mass. Right mandibular infundibulum is occluded and slightly expanded by soft tissue density.
Histopathology
Right maxillary cyst wall biopsy: Normal schneiderian mucosa, with acute and chronic (primarily plasmacytic) inflammation. There is no obvious cyst and no neoplasm is seen.
Case Discussion
Mucoceles most likely occur as a result of obstruction of the ostium with accumulation of mucus and eventual expansion of the sinus. They can become superinfected and represent a pyocoele.