Sphenoethmoidal Mucoceles with Intracranial Extension —Three Case Reports—

Abstract

Three unusual cases of sphenoethmoidal mucoceles with rare intracranial extension are reported. A 64-year-old female presented with a 7-month history of right visual disturbance. Computed tomography (CT) and magnetic resonance (MR) imaging demonstrated a huge mass in the right middle fossa. She underwent right frontotemporal craniotomy. Postoperatively, her proptosis and cranial nerve dysfunction had improved markedly. A 53-year-old female complained of headache, nausea , and dizziness. CT and MR imaging revealed a cystic mass filling the right sphenoid sinus. The cystic le sion was evacuated through the transnasal approach. She was doing well postoperatively and has been asymptomatic.A 39-year-old male complained of headache, vomiting, and right visual disturbance. CT and MR imaging demonstrated a homogeneous mass occupying the sphenoid sinus. Sphenoidotomy exposed the cyst extending superiorly into the anterior cranial fossa. He recovered from the visual disturbances and has been asymptomatic since. MR imaging provides confirmation of the diagnosis of sphenoethmoidal mucocele and is important for preoperative evaluation.

Clinical Analysis of Sphenoid Sinus Mucocele With Initial Neurological Symptoms

“…Initial symptoms of SSM are often vague and nonspecific, which routine examinations offer little diagnostic information, resulting in misdiagnosis and mistreatment. Huge lesions may lead to compression of the hypothalamus, brain, and the third ventricle . The most common clinical symptoms are headache, visual disturbance, and cranial nerve involvement .…”

Frontal Sinus Mucocele With Intracranial Extension Associated With Osteoma in the Anterior Cranial Fossa -Case Report-

“…6,7,19,20) In the absence of osteoma, the mucocele would develop towards the orbit, frontal sinus, or ethmoidal sinus. 2,4,8,9,17,18,23) In the present case, growth of the mucocele in the paranasal sinus was prevented by a giant osteoma, resulting in intracranial extension of the mucocele. Headache was the most common symptom in previous cases of intracranial mucocele secondary to osteoma.…”

The skull base: tumoral lesions

“…A large mass (white arrows) difficult to delineate from the surrounding soft tissues can be seen; location and signal characteristics could not lead to the final diagnosis. CT-guided biopsy with approach over the mandibular notch, anterior to the internal carotid artery (soft tissue contrast-enhanced CT not shown) provided the diagnosis: metastasis from mucoepidermoid salivary gland carcinoma illoma can all mimic tumoral lesions and can involve the skull base and eventually have intracranial extension [10].…”