Mucopiocele fronto-orbitária e transtorno comportamental: relato de caso / Intracranial mucopyocele and cognitive impairment: case report

Objetivo: Descrever uma patologia rara, de crescimento lento, com bom prognóstico se adequadamente tratada. Método: Análise e descrição de um caso de mucopiocele fronto-orbitária e transtorno comportamental, submetido ao tratamento cirúrgico no Hospital dos Servidores do Estado do Rio de Janeiro. Resultados: O paciente evoluiu com regressão completa dos sintomas prévios. Conclusão: Nas mucopioceles, os objetivos da cirurgia são: a confirmação do diagnóstico, a drenagem do conteúdo de muco e pus e a excisão ou marsupialização das paredes do cisto e da mucosa do seio comprometido. O diagnóstico correto dessa lesão leva à diminuição da morbidade e mortalidade, em virtude de o tratamento cirúrgico associado à antibioticoterapia venosa ser curativo.

Objective: To describe an uncommon pathology, slow-growing and good prognosis if well treated. Method: Analyze and description of fronto-orbital mucopyocele associated with cognitive impairment submitted a surgical treatment in Hospital dos Servidores do Estado do Rio de Janeiro. Results:Following the surgery all previous symptoms resolved. Conclusion: The objectives of surgery in mucopyoceles are diagnostic confirmation, drainage of secretion, excision or marsupialization of cyst walls and mucous of compromised sinus. The correct diagnosis reduces de morbidity and mortality since the surgical treatment associated with venous antibiotics is curative.

A Case of Mucopyocele of the Septated Maxillary Sinus

A 48-year-old man has felt discomfort and fullness of left eye for 4 months. He noticed left infraorbital mass 2 months ago and visited our clinic. The corrected visual acuity was 1.0 in both eyes. Exophthalmometry showed 12mm in the right eye and 14mm in the left eye (bar:100mm). A hard, non tender, immobile mass was palpable in the infraorbital area of the left eye. Computed axial tomography showed low density cystic mass with rim enhancement which extended from the anterior wall of the maxillary sinus to the infraocular area. At operation, the cystic mass had yellowish mucopurulent material and eroded the anterior wall of maxillary sinus and the orbital floor. The mass was not connected with the maxillary sinus. On the light microscopic examination, the cystic mass was lined with pseudostratified ciliated columnar epithelium and diagnosed as mucopyocele. Occasionally the sinus is congenitally divided by bony septa into two more or less separate cavities. In this case, the mucopyocele was thought to be originated from congenitally septated maxillary sinus presenting as infraorbital mass.