Mucocele and Mucopyocele

Fig. 53.1

Mucocele. Coronal T1-weighted precontrast MR image. The sphenoid is expanded and contains T1-hyperintense material. The normal pituitary gland is seen superior to the expanded sinus

Fig. 53.2

Mucopyocele. (a) Sagittal T1-weighted pre-gadolinium MR image. (b) Coronal T1-weighted post-gadolinium image. The sphenoid is markedly expanded, containing T1 shortening material. The superior margin of the expanded sinus effaces the sella, and the pituitary gland is not clearly visible

53.3 Histopathology

Mucoceles are epithelial-lined cystic masses demonstrating an inflammatory reaction and mucinous material. Pseudostratified, ciliated, columnar epithelium is commonly noted, often with metaplasia in recurrent or chronic lesions.
Mucoceles share many features with respiratory mucosa and may contain areas of granulation changes, necrosis, and hemorrhage [3, 14].

53.4 Clinical and Surgical Management

The mainstay of treatment is endonasal transsphenoidal marsupialization and drainage.
Endoscopic endonasal management with the use of angled lenses is the gold standard surgical procedure, which facilitates maximal drainage of disease located in the lateral sphenoid recesses [16].
Antibiotics are typically used to augment therapy.
Outcomes are usually excellent, with low recurrence rates if the lesion is treated early [1, 17, 18].

References

Soon SR, Lim CM, Singh H, Sethi DS. Sphenoid sinus mucocele: 10 cases and literature review. J Laryngol Otol. 2010;124:44–7.CrossRefPubMed

Saeger W, Ludecke DK, Buchfelder M, Fahlbusch R, Quabbe HJ, Petersenn S. Pathohistological classification of pituitary tumors: 10 years of experience with the German pituitary tumor registry. Eur J Endocrinol. 2007;156:203–16.CrossRefPubMed

Herman P, Lot G, Guichard JP, Marianowski R, Assayag M, Tran BA, Huy P. Mucocele of the sphenoid sinus: a late complication of transsphenoidal pituitary surgery. Ann Otol Rhinol Laryngol. 1998;107:765–8.CrossRefPubMed

Only gold members can continue reading. Log In or Register to continue