Introduction: To describe the unusual manifestation of a giant frontal sinus mucocele. Clinical Picture: A 33-year-old female presented with blurring of vision in the left eye, periorbital swelling and a painless forehead mass. There was proptosis, partial ptosis, and an elongated, soft, subcutaneous mass over the left side of the forehead. CT scan showed a mass arising from the frontal sinus with both intraorbital and intracranial extension. Treatment: Surgical excision of the mass confirmed the diagnosis of a mucocele. Outcome: Postoperatively, the patient was asymptomatic. Conclusions: A subcutaneous soft-tissue mass may be the presenting complaint of a frontal mucocele. Careful examination of the surrounding skin may suggest the diagnosis of sinus-related disease and thus direct appropriate investigations.
A mucocele is an epithelium-lined mucus-containing sac which usually develops when the ostium of a paranasal sinus becomes obstructed by chronic sinusitis, polyps or bone tumours. Mucoceles can erode through the surrounding bone and spread both intraorbitally and intracranially.1-4 We report an unusual case of a patient with intracranial extension of a frontal sinus mucocele who presented with a subcutaneous forehead mass.
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