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Pott puffy tumor

Case contributed by Mostafa Elfeky
Diagnosis almost certain

Presentation

Right supra-orbital swelling

Patient Data

Age: 45 years
Gender: Male

CT paranasal sinuses

ct

Near total opacification with soft tissue density and retained secretions of both maxillary, frontal, the ethmoid air cells and the upper nasal cavities bilaterally. Mild concentric mucosal thickening of both sphenoid sinuses. Associated thinning out and bony rarefaction of the ethmoid uncinate processes, intra-ethmoid bony septa, nasal turbinates and nasal septum. Flared ostio-meatal units, frontal outflow tract, nasal meati and spheno-ethmoidal recesses are obliterated.

There is soft tissue swelling by subgaleal collection connected to right frontal sinus contents through defective frontal bone. This is extending to form thin subperiosteal collection at the medial wall of the right orbit and thickening of the preseptal soft tissues.

Case Discussion

These features are mostly of chronic rhino-sinusitis with possibility of associated sinonasal polyposis. The defective anterior wall of the right frontal sinus with subgaleal, suborbital periosteal collections are representative of chronic osteomyelitis of the right frontal bone which is a complication of sinusitis, forming a frontal swelling formerly called "Pott's puffy tumor".

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