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Clinical Problem Solving: Radiology
April 2013

Radiology Quiz Case: Diagnosis

JAMA Otolaryngol Head Neck Surg. 2013;139(4):422. doi:10.1001/jamaoto.2013.147b

Diagnosis: Concha bullosa mucopyocele.

Comment. A mucocele of the paranasal sinuses differs from typical mucoceles in that it is a true mucus retention cyst with an epithelial lining most often caused by obstruction.1 This obstruction of normal mucociliary flow may be primary, or secondary to nasal polyps, facial trauma, sinus surgery, or tumors, and leads to an accumulation of mucoid fluid and the development of a slowly expanding mass.1 These become symptomatic owing to impingement of surrounding structures and can cause local bony destruction and remodeling. Mucoceles that become secondarily infected are called mucopyoceles. Mucoceles and mucopyoceles most commonly occur in the frontal and ethmoid sinuses but rarely can develop in a concha bullosa.

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