A 16-year-old boy treated conservatively for frontal sinusitis returns two weeks later with a boggy, fluctuant swelling over the forehead just above the glabella and low-grade fever. CT shows erosion of the outer table of the frontal bone. The most likely diagnosis is:

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

Explanation

Pott's puffy tumour is osteomyelitis of the frontal bone with subperiosteal abscess, a complication of frontal sinusitis classically in adolescent males whose diploic veins favour spread. It presents as a doughy, fluctuant swelling over the forehead with erosion of the outer table on CT. B mucocele expands slowly without fever or acute swelling, an osteoma is a slow-growing dense lesion, and preseptal cellulitis involves the eyelids rather than the forehead bone itself.

Reference: Dhingra's Diseases of Ear, Nose and Throat, 8th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.