Facial mucocele and brain complications: diagnostic priorities

Rebeca Sigüenza González,Santiago Pérez Fernández,Carlos Castañeda Cruz,Isabel Jiménez Cuenca

doi:10.1259/bjrcr.20190006

Rebeca Sigüenza González, Santiago Pérez Fernández + Show 2 more

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https://doi.org/10.1259/bjrcr.20190006

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Abstract

We present the case of a male with a history of nasal polyposis underwent bilateral nasosinusal endoscopic surgery. He went to the emergency department because of having behavioral changes and left frontal headache. An emergency CT showed nasal-sinus polyposis and several nodular lesions with a characteristic “ring” enhancement and perilesional edema. These findings were compatible facial mucocele complicated with rupture of the bone wall of the left frontal sinus and frontal abscess. Urgent surgery was performed, with left frontal craniectomy and drainage of the abscesses. Mucoceles are benign slowly growing lesions which can associate important complications. The most frequent are abscesses and the invasion of neighboring structures. It is very important to remember that frontal mucoceles can cause intracranial invasion when there is an erosion of the internal osseous table.

Highlights

We present the case of a male with a history of nasal polyposis underwent bilateral nasosinusal endoscopic surgery
Clinical presentation A 79-year-old male with a history of nasal polyposis underwent bilateral nasosinusal endoscopic surgery. He went to the emergency department because of having behavioral changes from 20 days ago and left frontal headache for 1 month
Other important feature was the complete occupation of both frontal sinuses, with a bone defect in the posterior wall of the left frontal sinus (Figure 2)

Summary

Introduction

We present the case of a male with a history of nasal polyposis underwent bilateral nasosinusal endoscopic surgery. Other important feature was the complete occupation of both frontal sinuses, with a bone defect in the posterior wall of the left frontal sinus (Figure 2). These findings were compatible facial mucocele complicated with rupture of the bone wall of the left frontal sinus and frontal abscess.

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