A rare case report of unilateral giant sphenochoanal polyp with sphenoidal mucocele

Abstract

Sphenochoanal polyp is a rare benign tumour arising from sphenoid sinus. The most common presenting complaint is gradually progressing nasal obstruction. Clinically, it mimics antrochoanal polyp and differentiated using nasal endoscopy, computer tomography and magnetic resonance imaging of the paranasal sinuses. Functional endoscopic sinus surgery (FESS) is the treatment of choice. Whereas mucous retention cyst of sphenoid is one of the rarer conditions. It develops due to obstruction of seromucinous gland of sinus mucosa, resulting in accumulation of mucus causing dilatation of the gland. Retention cysts and polyposis are infrequent in sphenoid sinus compared to other paranasal sinuses. Main clinical presentation of sphenoid mucocele is due to its pressure effects on surrounding structures, causing headache, diminished vision, ophthalmoplegia or intracranial complications. Sometimes, it remains undiagnosed and comes out as an accidental finding during surgery as occurred in our case. Patients with complaints must go under surgical removal of cyst and polypoidal mass. We report a case of a 23-year-old male presenting with unilateral nasal obstruction, headache, periorbital swelling, and a history of recurrent paranasal sinus infections. He was diagnosed with a sphenochoanal polyp based on investigations but underwent FESS, during which a sphenoid mucocele was discovered as an incidental finding.