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Neurological picture
A giant subcutaneous forehead abscess and epidural extension caused by frontal mucocele
  1. I Takumi1,2,
  2. M Goto3,
  3. M Akimoto1,4
  1. 1
    NMS Cranio-Facial Institute, Nippon Medical School, Inba-gun Inba-mura, Chiba, Japan
  2. 2
    Department of Neurosurgery, Nippon Medical School Chiba Hokuso Hospital, Inba-gun Inba-mura, Chiba, Japan
  3. 3
    Department of Otolaryngology, Nippon Medical School Chiba Hokuso Hospital, Inba-gun Inba-mura, Chiba, Japan
  4. 4
    Department of Plastic and Reconstructive Surgery, Nippon Medical School Chiba Hokuso Hospital, Inba-gun Inba-mura, Chiba, Japan
  1. Correspondence to Professor M Akimoto, Department of Plastic and Reconstructive Surgery, Nippon Medical School Chiba Hokuso Hospital, 1715 Kamagari, Inba-gun Inba-mura, Chiba 270-1694, Japan; akimoto{at}nms.ac.jp

http://dx.doi.org/10.1136/jnnp.2009.172494

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    A 26-year-old Japanese man visited our clinic because of a huge forehead protrusion (fig 1A) with acute onset. He was under treatment for asthma, nasal allergies and chronic bronchitis. CT and MRI images revealed erosive defects at the inner and outer layers of the frontal bone and communication between the frontal sinus and both the subcutaneous space (fig 1B,D) and the epidural space (fig 1C,E), suggesting a frontal mucocele resulting in a subcutaneous abscess and epidural extension (arrowhead).

    Figure 1

    (A) Macroscopic photograph of a huge subcutaneous tumour in the middle of the forehead. CT scans demonstrate (B) erosion of the outer-table of the calvarium and the adjacent subcutaneous …

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    Footnotes

    • Funding This work was supported by the Mitsui Life Social Foundation.

    • Competing interests None.

    • Ethics approval Ethics approval was provided by the Nippon Medical School Musashikosugi Hospital Research Ethics Advisory Board.

    • Patient consent Obtained.