Frontoethmoidal mucocele

Case contributed by Dr Mostafa El-Feky

Presentation

Left sinonasal expansion with left proptosis

Patient Data

Age: 15 years
Gender: Male
MRI

Paranasal sinuses

Total opacification of the left ethmoidal air cells, frontal sinus, and both sphenoid sinuses with marked expansion of the frontal and ethmoids.

The following signal pattern in MRI:

  • iso- to high signal on T1, high signal on T2 with an area of low signal (protein-rich content)
  • markedly thin rim mucosal enhancement following gadolinium
  • no central enhancement. 
  • marked lateral bulge of the left lamina papyracea, stretching the medial rectus. A 15 mm dehiscence is noted anteriorly.

Clear peri-sinus fat planes. No aggressive osseous erosions. Preserved nasal mucosal enhancement. No upper cervical lymphadenopathies.  

Small retention cyst of the left maxillary antrum.

Mild mucosal thickening of the right frontal sinus and ethmoidal air cells.

The nasal septum is deviated towards the right side.

Case Discussion

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

 

Case courtesy Prof.Dr. Mohamed Eid, professor of radiology, Alexandria university, Egypt.

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Case information

rID: 77114
Published: 22nd May 2020
Last edited: 23rd May 2020
System: Head & Neck
Inclusion in quiz mode: Included
Institution: Dar El Ashaa Center

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