Localized Paget's disease with mucocele in the sphenoid sinus

An Uncommon Osseous Frontal Sinus Tumor: Monostotic Paget's Disease

Paget's disease of the bone is a disorder characterized by abnormal breakdown and formation of bone tissue. The cause is believed to be either viral or genetic in origin. Most of the time, patients are asymptomatic. Diagnosis is supported by findings from multiple modalities including serum markers, imaging, bone scans, and histology. We present a rare case of Paget's disease of the bone involving the frontal sinus. We review the relevant clinical, diagnostic, and histological findings. We also suggest indications for the management of monostotic Paget's disease of the frontal sinus.

Mucoceles of the sphenoid sinus

PURPOSE

Mucoceles of the sphenoid sinus represent 1-2% of all paranasal sinus mucoceles. The aim of this paper is to report our experiences in patients with mucoceles of the sphenoid sinus.

PATIENTS AND METHOD

In a period of 4 years, we observed six patients in whom a mucocele of the sphenoid sinus was suggested pre- or intraoperatively. Symptoms and signs included headache, visual loss and palsies of the III and VI cranial nerve. All patients were investigated by MRI and/or CT. Imaging findings were compared with operative and/or histological findings.

RESULTS

In three cases there were simple mucoceles, in one case we found a tumour (nasopharyngeal carcinoma) associated mucocele and in two cases, malignant tumours (carcinoma, chordoma) imitated a mucocele. The diagnosis of simple mucoceles was no problem at all by imaging. Difficulties made the two malignant tumours and the tumour associated mucocele. In the first two cases, repeated histological samples were necessary to make the final diagnosis.

CONCLUSION

Mucoceles of the sphenoid sinus should be investigated and handled very carefully with regard to differential diagnoses and tumour associated cases.