Mucin impaction tumor of the paranasal sinuses: a new clinical entity?

A variety of uncommon benign lesions occur in the paranasal sinuses and have been reported to masquerade as carcinomas. Nearly all of such cases have been limited to the frontal, sphenoid, and ethmoid sinuses with an isolated report of maxillary sinus involvement. The classic roentgenologic picture is that of bony destruction. Heretofore described destructive lesions of the maxillary sinus include the mucocele, mucous retention cyst, pseudocyst, pyocele and cholesteatoma. This report deals with a previously undescribed entity, the mucin impaction tumor located in a septate maxillary sinus. This inflammatory, non-neoplastic tumor-like condition, presents as chronic sinusitis with periorbital edema, malar swelling and tenderness. Radiologic examination reveals total destruction of the bony walls of the nose, of the orbital rim and floor and of the maxillary sinus. The importance of recognizing this lesion lies in its benign nature but destructive capabilities. The destruction may possibly be accounted for by its anatomical origin in the septate sinus. Repeated surgical intervention may also serve to predispose or potentiate development of these lesions. Its resolution after adequate surgical extirpation and its place in the differential diagnosis of antral lesions are worthy of emphasis.