A Rare Case of Orbital Mucocele

Ana Lazarova

University Clinic for Surgery Disease St.Naum Ohridski Skopje, R. Macedonia

Dr. Ana Lazarova, University Clinic for Surgery Disease St.Naum Ohridski Skopje, R. Macedonia.

Keywords: Orbital Mucosele; Optic Nerve; Sinus

Abstract

Introduction
Orbital mucoceles are cysts which are filled with mucous fluid that cannot naturally drain from the nose. Most common arising from the ethmoid or frontal sinuses they grow and slowly cause mass effect of the adjacent orbital tissues.
Case Report
This is a case of 46 years old patient who present with symptoms of exophthalmos and pain in the right eye, in a period of one year. After ophthalmology examination he was send for magnetic resonance imaging (MRI) of the orbital cavity to be done. MRI was done in standard T1 and T2 waited images and waited images after contrast administration. In the right orbital cavity lokalizated in the extraconal space adherent to the ethmoidal cellules, oval homogenous tumor formation with the diameter of 26mm was found. This formation was with intermediate signal intensity in T1 waited images and low signal intensity in T2 waited images which suggested that is present like a solid tissue, because is protein -rich content. In the waited images after contrast administration there was periphery contrast enhancement. There was no invasion of the optic nerve or other conal eye structures, but there was mass effect of the medial rectus muscle with the displacement of all conal structures laterally. The lateral wall of ethmoidal cellules was disrupted and part of them next to the tumor were displaced Also computer tomography (CT) scan was preformed, for better evaluation of the sinus structures as additional investigation. The density of solid tissue was confirmed and no calcification in it was found. Neurosurgery with Misonix ultrasonic knife was performed and encapsulated dense cystic formation was found and send to pathohistology verification with the result for mucocele.

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