Paranasal sinus carcinoma causing orbital mucocele

Area of Science:

• Ophthalmology
• Otorhinolaryngology
• Pathology

Background:

• Orbital mucoceles are typically benign cystic masses arising from paranasal sinuses.
• Diagnosis is often based on clinical presentation and imaging.
• Malignant transformation or concomitant malignancy is rare but possible.

Observation:

• Three patients presented with clinical and imaging findings suggestive of typical orbital mucoceles.
• Initial assessment did not raise suspicion for malignancy.

Findings:

• Histopathologic examination unexpectedly revealed concomitant squamous cell carcinoma in the paranasal sinuses of all three patients.
• The mucoceles were found to be associated with, rather than arising from, the malignancy.

Implications:

• This case series highlights the critical need for thorough histopathologic investigation of all suspected orbital mucoceles.
• Relying solely on clinical or initial imaging may lead to missed diagnoses of underlying paranasal sinus squamous cell carcinoma.
• Histologic review is essential to differentiate benign mucoceles from potentially life-threatening malignancies.