Mucocele of the anterior clinoid process: case report.

OBJECTIVE AND IMPORTANCE Of the primary intracranial mucoceles, those arising from the optic canal or anterior clinoid process are extremely rare. To our knowledge, only five cases have been reported. The pathogenesis of mucoceles at this unusual site is unclear, but the previously reported cases suggest that these mucoceles may originate from pneumatizing air cells in the anterior clinoid processes. CLINICAL PRESENTATION A 43-year-old woman presented with diplopia. Magnetic resonance imaging showed a small mass, compressing the optic nerve, in the medial portion of the left anterior clinoid process. The medial portion of the anterior clinoid process surrounding the mass was eroded and the bony margins of the mass were well corticated in computed tomographic scans. There was no direct connection between any paranasal sinus and the mass cavity, as assessed in imaging studies and intraoperatively confirmed. The pathological diagnosis after the operation indicated a mucocele. CONCLUSION Considering the absence of air cells in the anterior clinoid processes, the mucocele in this case might have originated from ectopic mucinous tissue that appeared during the development of the optic canal, rather than from a pneumatizing air cell.

[1]  C. Heilman,et al.  Anterior Clinoid Mucocele Masquerading as Retrobulbar Neuritis , 1996, Ophthalmic plastic and reconstructive surgery.

[2]  R. Delfini,et al.  Mucoceles of the Paranasal Sinuses with Intracranial and Intraorbital Extension , 1993 .

[3]  R. Delfini,et al.  Mucoceles of the paranasal sinuses with intracranial and intraorbital extension: report of 28 cases. , 1993, Neurosurgery.

[4]  G. Fullerton,et al.  Chronically obstructed sinonasal secretions: observations on T1 and T2 shortening. , 1989, Radiology.

[5]  J. Hesselink,et al.  Mucocele of the anterior clinoid process: CT and MR findings. , 1989, Journal of computer assisted tomography.

[6]  P. Van Tassel,et al.  Mucoceles of the paranasal sinuses: MR imaging with CT correlation. , 1989, AJR. American journal of roentgenology.

[7]  F. Chan,et al.  Optic canal syndrome due to posterior ethmoid sinus mucocele. Case report. , 1986, Journal of neurosurgery.

[8]  R. Yee,et al.  Magnetic resonance imaging of craniopharyngioma. , 1986, American journal of ophthalmology.

[9]  R. Yee,et al.  Sphenoid sinus mucocele (anterior clinoid variant) mimicking diabetic ophthalmoplegia and retrobulbar neuritis. , 1986, American journal of ophthalmology.

[10]  C. Lui,et al.  Mucocele of the sphenoid sinus with the apex orbitae syndrome. , 1986, Surgical neurology.

[11]  D. Mattox,et al.  Anatomy of the ethmoid sinus. , 1985, Otolaryngologic clinics of North America.

[12]  T. Asakura,et al.  Giant mucocele of paranasal sinuses. , 1985, Surgical neurology.

[13]  Jonathan D. Wirtschafter,et al.  Relationship of optic neuritis to disease of the paranasal sinuses , 1984, The Laryngoscope.

[14]  H. Nishimura,et al.  Circular enlargement of the optic canal caused by paranasal sinus mucocele. , 1983, Surgical neurology.

[15]  S. Sellars,et al.  The sphenoid sinus mucocoele , 1981, The Journal of Laryngology & Otology.

[16]  A. Osborn,et al.  Mucocele of the petrous temporal bone. , 1979, AJR. American journal of roentgenology.

[17]  R. Gacek,et al.  Mucocele of the petrous apex , 1979, The Journal of Laryngology & Otology.

[18]  T. E. Larsen,et al.  Mucocele of the paranasal sinuses , 1978, The Journal of Laryngology & Otology.

[19]  F. Diaz,et al.  Mucoceles with intracranial and extracranial extensions. Report of two cases. , 1978, Journal of neurosurgery.

[20]  B. Bloor,et al.  Sphenoid sinus mucoceles. , 1970, Journal of neurosurgery.

[21]  J. Pool,et al.  Osteomas and mucoceles of the frontal paranasal sinuses. , 1962, Journal of neurosurgery.

[22]  T. Olin,et al.  Muco-pyocele of sphenoidal sinus or posterior ethmoidal cells with special reference to the apex orbitae syndrome. , 1961, Acta oto-laryngologica.

[23]  E. Wolff.  The Anatomy of the Eye and Orbit , 1949, Nature.

[24]  O. E. V. Alyea.  SPHENOID SINUS: ANATOMIC STUDY, WITH CONSIDERATION OF THE CLINICAL SIGNIFICANCE OF THE STRUCTURAL CHARACTERISTICS OF THE SPHENOID SINUS , 1941 .