Question

A 30-year-old male presents with nonaxial proptosis of the left eye. The patient gives a history of a road traffic accident 15 years back. The CT image is given below. What is the most likely diagnosis?

• A. Frontal mucocele
• B. Frontal meningioma
• C. Juvenile nasopharyngeal angiofibroma
• D. Pseudotumor of orbit

Answer 1

The Correct Option is A

A 30-year-old male presents with nonaxial proptosis of the left eye. Given the patient's history of a road traffic accident 15 years ago and the CT image provided, the most likely diagnosis is a Frontal Mucocele. This condition occurs due to the accumulation of mucus in a paranasal sinus, most commonly the frontal sinus, leading to expansion and bone erosion over time. The key details supporting this diagnosis include:

• History of Trauma: The patient's accident could have led to damage, blockage, or scarring in the frontal sinus, predisposing him to mucocele formation over the years.
• Proptosis Presentation: Nonaxial proptosis occurs because the expanding mucocele exerts pressure on the orbit from the frontal sinus. Frontal mucoceles typically cause an inferior and anterior displacement of the eye, consistent with the patient's presentation.
• CT Imaging: The CT scan likely shows an opacified, expansile lesion within the frontal sinus, causing thinning or erosion of adjacent bone. These imaging characteristics are classic for a mucocele.

Other options such as Juvenile Nasopharyngeal Angiofibroma are less likely due to the patient's age and gender (more common in adolescent males) and typical location (nasal cavity), while Pseudotumor of the Orbit and Frontal Meningioma would present with different imaging findings.