Jonathan M. Sykes

Sphenoethmoid mucocele with intracranial extension: Radiologic diagnosis

Mucoceles of the paranasal sinuses result from accumulation of mucous secretions within an obstructed sinus cavity. These masses gradually enlarge and are frequently asymptomatic. Patients may report experiencing pressure or headaches as the collection of inspissated mucus expands and slowly destroys surrounding structures. Mucoceles of the frontal, maxillary, and anterior ethmoid sinuses are relatively common, but those that arise in the sphenoid and posterior ethmoid sinuses are rare. Intracranial extension of sphenoethmoid sinus mucoceles is extremely rare, and can be confused with other intracranial disease processes. 3 We present a patient with a large sphenoethmoid sinus mucocele with intracranial extension. Computerized tomography (CT) and magnetic resonance imaging (MRI) were crucial in the preoperative evaluation.

Plasma cell granuloma of the paranasal sinuses

The plasma cell granuloma of the upper aerodigestive tract is a benign lesion which consists of sheets of mature plasma cells that can be mistaken for a malignant tumor. The diagnosis of plasma cell granuloma can only be made after morphologic examination. In some cases, it may be difficult to determine whether the plasma cell infiltrate is reactive or neoplastic. Malignant lesions that can be mistaken for plasma cell granuloma include plasmacytoma, malignant melanoma, hematopoietic neoplasms, olfactory neuroblastoma, anaplastic carcinoma, and metastasis. The location of the tumor may be helpful in making diagnosis. Plasma cell granulomas most coinmonly manifest as solitary coin lesions in the lungs. I Plasma cell granulomas have also been reported in the stomach, renal pelvis, kidney, spinal cord meninges, gingiva, intracranial region/ and tonsil. We are the first to report a plasma cell granuloma of the paranasal sinuses, a location where plasmacytomas are frequently found.: