PMC9452216_01
(A-D) The muocele is composed of two separate parts. T1-weighted magnetic resonance imaging (MRI) scan (A, axial) shows a hyperintense part (black star: high protein content) and a mildly hyperintense part (white arrow: high water content). T2-weighted MRI scans (B, axial; C, coronal) shows a hypointense part centrally, with a surrounding rim of hyperintense mucosa (black star) and a part of a high signal. MRA scan (D) shows normal arterial vasculature and a mucocele. (E-G) Six months later, brain MRI was re-evaluated. It showed no changes in size, but minimal changes in signal intensity of the lesion. The T2-weighted signal is lower than expected in the part of high water content (white arrow), indicating the increase of protein within the mucocele. (H) After wide sphenoidotomy, the blackish cystic mass (black star) was found and completely removed by endoscopic surgery.
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However, it revealed a cystic lesion in the right sphenoid sinus, without erosion of the bony wall (Fig. 1). Six months later, brain MRI was re-evaluated because of his ongoing and aggravated headache; it showed no change in size, but minimal changes in signal intensity (Fig. 1). After the right-sided sphenoidotomy, a brownish cystic mass was found and excised completely (Fig. 1).