A patient sustained a comminuted fracture of the frontal sinus involving the nasofrontal duct five years ago and declined follow-up. He now presents with a slowly enlarging mass above the medial canthus. The most likely pathology is:

• A Osteosarcoma of the frontal bone
• B Pott's puffy tumour
• C Osteoma of the frontal sinus
• D Frontal mucocele ✓

Explanation

Injury to the nasofrontal duct obstructs mucosal drainage, and retained secretions lined by trapped sinus mucosa gradually expand as a mucocele, eroding the walls and presenting years later as a mass near the medial canthus or forehead. Secondary infection converts it to a mucopyocele. An osteoma grows slowly from bone and is unrelated to prior trauma, osteosarcoma would show destructive malignant imaging features, and Pott's puffy tumour is subperiosteal abscess complicating acute frontal sinusitis.

Reference: Scott-Brown's Otorhinolaryngology and Head and Neck Surgery, 8th ed.

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Written and medically reviewed by the StethoPrep medical team.