Giant mucocele originating from the middle concha in a 5-year-old child: a case report

Abstract

Introduction: Mucoceles are mucus-filled, epithelial-lined sacs that slowly develop in the paranasal sinuses when sinus or concha bullosa drainage is obstructed by inflammatory processes, trauma, or prior surgery. They are extremely rare in children. Symptoms usually arise from the nasal obstruction or compression of neighboring structures.

Case presentation: This case report describes a 5-year-old Turkish boy with a 3-year history of nasal obstruction. A computed tomography scan showed a well-defined soft tissue density lesion, seemingly originating in the region of the middle concha and was suggestive of a middle concha mucocele. The mass was removed by endoscopic sinus surgery.

Conclusions: In the case of a child presenting with nasal obstruction, mucocele should be remembered in the differential diagnosis of intranasal tumors. Computed tomography and magnetic resonance imaging are helpful in making the diagnosis and endoscopic nasal surgery has proven successful in the treatment.

Figure 1

Coronal (A), axial (B), and sagittal (B,C) paranasal sinus computed tomography images showing a mucocele of the nasal cavity. (A) Coronal image showing the extensive mucocele filling the nasal cavity without orbital extension. The nasal septum has deviated to the left side due to the mass effect (white arrows). (B) Axial image showing the originating site of the mucocele from the middle concha (white arrowhead). (C) Sagittal image of the mucocele. Note that the cranial base is intact without extension into the cranial fossa (thin white arrows).

Figure 2

Coronal paranasal sinus computed tomography images 2 months after the operation showing no signs of recurrence or inflammation.

Figure 3

Histopathologic microphotograph of the benign cyst wall. The microphotograph shows a benign cyst lined by ciliated columnar mucin-secreting cells (white arrows) with no secondary changes due to infection or hemorrhage; dyed with hematoxylin and eosin stain under 40 × magnification.