Isolated extra-sinus subcutaneous mucocele: A case report

• Published in: International journal of surgery case reports 2023-08, Vol.109, p.108488, Article 108488
• Main Authors: Alouda, Nada, Alkhiary, Hattan, Alsaleh, Saad
• Format: Article
• Language: English
• Subjects: Case Report; Extra-sinus; Frontal sinus mucocele; Isolated mucocele; Trans-septal
• ISSN: 2210-2612; 2210-2612
• DOI: 10.1016/j.ijscr.2023.108488

Paranasal sinus mucoceles are epithelialized cystic masses formed through the accumulation of sterile mucus. Mucoceles are expansile lesions, and their symptoms change according to their extension into the surrounding structures: anteriorly to the subcutaneous tissue, laterally to the orbit, or posteriorly to the cranium. Herein, we report the case of a pediatric patient with an isolated subcutaneous mucocele with no sinus connection. Physical examination revealed a non-tender fluctuating round mass approximately 4 cm in diameter in the right supraorbital region. Computed tomography and magnetic resonance imaging findings suggested a mucocele, and the diagnosis was confirmed via histopathological examinations postoperatively. The patient underwent a combined surgical approach that included an endoscopic transseptal approach to the frontal sinus with a right sub-brow incision and drain placement. The right frontal sinus was opened, and the mucocele was marsupialized. At the 3-month follow-up visit, the frontal sinus neo-ostium appeared patent on endoscopic examination, and the frontal sinuses were clear on imaging. The optimal treatment for frontal mucoceles is marsupialization and adequate sinus drainage. As the patient had an isolated subcutaneous extra-sinus mucocele above the orbit, a combined approach was used to ensure thorough removal of the lesion to reduce the recurrence rate. This report emphasizes the importance of using a combined approach for the removal of lesions and limiting the potential risk of recurrence in similar cases. •A pediatric patient presented with an atypical isolated supraorbital subcutaneous mass.•The mass was an isolated subcutaneous mucocele lesion without sinus connection.•An endoscopic transseptal approach to the frontal sinus with a right sub-brow incision and drain placement was used.•At the follow-up, the frontal sinus neo-ostium was patent on endoscopic examination.•The combined approach limits the potential risk of recurrence in similar cases.