Giant fronto-ethmoido-orbital mucocele. Multidisciplinary management about a case at Saint Joseph Hospital in Kinshasa, Democratic Republic of the Congo

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Introduction: Sinus mucocele is a benign cystic tumor which evolves slowly and may be responsible for ophthalmological and endocranial complications. In this context, its management may require multidisciplinary expertise, which may be lacking in an environment with limited resources. Case Report: We report the case of a 38-year-old female patient with an ocular globe protuberance and redness of the right eye that had been evolving for several years without consulting specialized services. In the ENT and Ophthalmology Departments, the clinical signs were dominated by axile exophthalmos and visual impairment on the right eye. Computed tomography (CT) scans of the sinuses revealed a mucocele of the right frontal sinus with osteolysis and grade 2 exophthalmos, as well as an extra-conical process of the right orbit with lysis of the anterior and posterior walls of the right frontal sinus and the anterior and posterior ethmoidal cells. This required remote expertise from an ophthalmologist specialized in orbital diseases and a neuroradiologist to confirm the diagnosis of mucocele. Surgical treatment using the fronto-eyebrow approach of Jacques was performed and the post-operative outcome was satisfying six months later. Conclusion: Fronto-ethmoid-orbital mucocele is a rare condition in our settings. Multidisciplinary expertise and remote expertise can be of great value in the diagnosis and choice of treatment in an environment with limited resources.

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