Mucopiocelo fronto-etmoidal, a propósito de um caso clínico

Abstract

Mucocele is an expansive cystic benign lesion of the sinuses. The superinfection, called mucopyocele, may lead to a rapid growth period, more prone to complications. The authors present the case of a 59 years old female patient, who was admitted to the Emergency Service after inaugural generalized tonic-clonic seizure, with complaints of right periorbital swelling and fever since one week. Physical examination showed orbital cellulitis and infero-external proptosis, with an area of fluctuation in the inside of the right upper eyelid, chemosis and ophthalmoplegia of the right eye accompanied by mucopurulent rhinorrhea. CT demonstrated massive right subperiosteal abscess at the inner wall of the orbit, apparently starting from the ipsilateral anterior ethmoid cells and frontal sinus. A fronto-ethmoidal mucopyocele was suspected. She underwent emergency eye surgery with drainage of the abscess and endoscopic sinus surgery with marsupialization of the frontoethmoidal lesion. The patient experienced complete recovery. Although considered benign lesions, mucoceles present destructive potential, especially if infected, sometimes requiring emergency surgery. The endoscopic treatment of these lesions is reaffirmed as the treatment of choice.