Pott puffy tumour with cerebral abscess

Case contributed by Dr Mahomed A. Osman

Presentation

Headaches and chronic sinusitis.

Patient Data

Age: 30
Gender: Male

The right maxillary sinus and bilateral frontal sinuses are completely opacified. There is a small area of soft tissue attenuation in the posterior maxillary sinus and an even smaller area on the anterior wall. The right sphenoid sinus is clear although there is a soft tissue density projection at the superoanterior wall of the left sphenoid sinus. The right agger nasi is opacified.

There is soft tissue swelling over the forehead, under which the frontal bone contains a small lytic defect consistent with possible osteomyelitis. Findings are suggestive of sinusitis with Pott puffy tumour.

CT

Follow up CT after two weeks, ongoing headache.

There is a large left frontal ring enhancing lesion with considerable mass effect resulting in midline shift to the right and almost complete compression of the left lateral ventricle . This is consistent with a cerebral abscess in the setting of sinusitis.

Case Discussion

A Pott puffy tumour is a non-neoplastic swelling of the forehead and is a recognised complication of acute sinusitis. The swelling is inflammatory in nature and results from subperiosteal abscess and osteomyelitis, of usually the frontal sinus.

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Case information

rID: 24960
Case created: 24th Sep 2013
Last edited: 4th Dec 2015
System: Head & Neck
Inclusion in quiz mode: Included

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