Two Cases of Mucocele After Orbital Fracture Repair

Young Kyo Kwun; Yoon-Duck Kim

doi:10.3341/jkos.2009.50.4.612

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Kwun and Kim: Two Cases of Mucocele After Orbital Fracture Repair

Original Article

J Korean Ophthalmol Soc 2009;50(4):612-617.

Published online: 7 September 2009

DOI: https://doi.org/10.3341/jkos.2009.50.4.612

Two Cases of Mucocele After Orbital Fracture Repair

Young Kyo Kwun, MD, Yoon-Duck Kim, MD

Department of Ophthalmology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea

Address reprint requests to Yoon-Duck Kim, MD, Department of Ophthalmology, Samsung Medical Center, Sungkyunkwan University School of Medicine #50 Ilwon-dong, Gangnam-gu, Seoul 135-710, Korea Tel: 82-2-3410-3561, Fax: 82-2-3410-0074, E-mail: ydkimoph@skku.edu

Received 11 September 2008 Accepted 24 November 2008

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Purpose

We report two cases of mucocele formation after medial orbital wall fracture repair with an alloplastic implant.

Case summary

A 61‐ year‐ old man with a history of a medial orbital wall fracture repaired with an alloplastic implant five years earlier presented with a several‐ month history of left proptosis without diplopia, pain, or lid edema. A 55‐ year‐ old man with a history of a medial orbital wall fracture repaired with an alloplastic implant seven years prior, presented with a five‐ year history of left proptosis with diplopia. Computed tomography (CT) scans revealed a large cyst on the orbital medial wall, which surrounded the alloplastic implant and had no definite enhancement. The patients underwent orbital surgery to remove both the cyst and implant. Histologic examination of the cyst revealed a capsule lined with ciliated pseudostratified columnar epithelium. Both patients had an uncomplicated postoperative course with resolution of the proptosis.

Conclusions

For cases that present with late proptosis after orbital fracture repair, mucocele formation should be included in the differential diagnosis.

Keywords: Mucocele, Orbital fracture repair

References

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Figure 1.

A 61-year-old man with a history of a medial orbital wall fracture repaired with an alloplastic implant 5 years earlier, presented with a several‐month history of left proptosis.

Figure 2.

Axial (A) and coronal (B) orbit CT scans show a large cystic mass adjacent to the medial wall of the orbit. Axial (C) and coronal (D) MRI scans of the orbit show a large cystic mass that has high signal intensity in T1-, T2-weighted image.

Figure 3.

A 55-year-old man with a history of a medial orbital wall fracture repaired with an alloplastic implant 7 years before, presented with a 5-year history of proptosis in the left eye.

Figure 4.

Pre‐ (A) and post‐contrast (B) orbit CT scans show a cystic mass adjacent to the medial wall of the orbit with no definite enhancement.

Figure 5.

The large cysts (A, B) surrounding the Supramid implant.

Figure 6.

Histopathology (A, B) of the cyst walls (hematoxylin and esoin stain: original magnification ×400). The wall of the cysts are lined with ciliated pseudostratified columnar epithelium.

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