PMC4927218_01
Pre-operative CT showed soft-tissue shadowing in the frontal sinus, with cystic enlargement to the posterior wall of the right frontal sinus; bone thinning was also noted. Soft tissue shadowing was also observed in the right anterior ethmoid sinus.
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Soft tissue shadows in the patient's upper-right ethmoid sinus and a large cyst in the right frontal sinus accompanied by bone thinning were observed according to CT performed at our hospital (Figure 1).
MRI showed brain abscess and edema on the frontal lobe due to inflammation of giant frontal sinus pyocele: (a) T1-weighted image, (b) T2-weighted image, and (c) contrast-enhanced T1-weighted.
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Hypointensity was observed on T1-weighted images (Figure 2(a)) and hyperintensity on T2-weighted images (Figure 2(b)). A ring-shaped mass with an inner diameter of 1.5 cm and surrounding edema were observed in the right frontal lobe (Figures 2(b) and (c)). Contrast enhancement was seen on the margins of the frontal sinus pyocele and cerebral abscess (Figure 2c).
Postoperative CT showed no cyst in the frontal sinus posterior wall.
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Two months postoperatively, a CT exam showed that the cyst had disappeared from the posterior wall of the frontal sinus (Figure 3).
Postoperative MRI showed high signal of the fat in the frontal sinus but did not show any abscesses.
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An MRI performed after 4 months from the patient discharge disclosed hyperintensity in the frontal sinus which was thought to be fat, but no signs of abscess (Figure 4).