Giant Ethmoid Mucocele Presenting as an Orbital Mass

Abstract

Mucocele is a benign and expansile cystic lesion lined with respiratory mucosa of pseudo stratified columnar epithelium. Mucocele most commonly produces bone destruction within the paranasal sinuses. It mostly involves the frontal sinus followed by ethmoid and rarely sphenoid and maxillary sinuses. We report a case of giant ethmoid mucocele who presented with history of progressive unilateral protrusion of eye since 5 years. CT scan revealed a large mucocele of the ethmoid sinus with orbital extension on the same side. He was successfully treated with endoscopic sinus surgery.

Giant ethmoid mucocele presenting as a nasal region mass with intracranial extension, a case report

“…Sinus wall expansion may compress optic nerve or compromise its blood supply leading to optic atrophy. Intracranial extension through erosion of the posterior wall of the frontal sinus can result to meningitis or CSF fistula, orbital cellulitis, meningitis, and brain abscess [1] .…”

“…Computed tomography and MRI are effective in detecting the lesion and in demonstrating any intracranial extension [2] . Paranasal sinus mucoceles can be effectively treated using the transnasal endoscopic approach and marsupialization with complete recovery reported in 82%-96% of cases, while an extranasal approach can be used for recurrence [1] . Giant ethmoid mucoceles are rare which have large extracranial and intracranial extensions and present as craniofacial disfigurement.…”

“…Mucocele is expansile cystic lesion which is benign and lined with pseudo-stratified columnar epithelium respiratory mucosa [1] . It is slowly growing lesion that occurs as a result of occlusion of the ostia of the paranasal sinuses by benign neoplasms (e.g., osteomas and fibrous dysplasias), by malignant or metastatic tumors, and by an intrasinusal accumulation of excreted substances secondary to infection, allergy, or trauma [2] .…”

“…It is slowly growing lesion that occurs as a result of occlusion of the ostia of the paranasal sinuses by benign neoplasms (e.g., osteomas and fibrous dysplasias), by malignant or metastatic tumors, and by an intrasinusal accumulation of excreted substances secondary to infection, allergy, or trauma [2] . Mucocele most commonly produces bone destruction within the paranasal sinuses and mostly involves the frontal sinus followed by ethmoid and rarely sphenoid and maxillary sinuses [1] .…”