Sinonasal fibrous dysplasia with frontal sinus mucocele

Case contributed by Mostafa Elfeky
Diagnosis almost certain

Presentation

Right proptosis.

Patient Data

Age: 70 years
Gender: Female

Expansion and sclerosis of the right frontal bone, involving the right orbital roof which also shows a cystic component measuring 2x3 cm.

The frontal sinuses are nearly obliterated.

An expansile right frontal bone intradiploic osteolytic lesion, showing thin lobulated bony wall, and focal posterior wall interruptions. It is measuring 2.3 x 3.2 x 2.8 cm in AP, SS and CC dimensions. It shows internal fluid signal of T1 high signal, T2 marginal high and central low intensity signal, and no diffusion restriction. It is anteromedially connected to the small-sized right frontal sinus. Unremarkable adjacent brain parenchyma.

2nd presentation after 5mths

mri

Denovo right orbital lateral wall subperiosteal extension noted measuring 2.6 x 1 cm in AP, SS dimensions.

Case Discussion

Features are suggestive of bilateral frontal sinuses fibrous dysplasia and associated right frontal mucocele formation with lateral orbital subperiosteal extension. Frontal sinus mucocele is a rare association with fibrous dysplasia of frontal sinuses.

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