Sphenoid giant mucoceles leading to left hemianopia.

Introduction: Paranasal sinus mucocele is defined as the accumulation and retention of mucoid secretion within the sinus, leading to distension and erosion of its bony walls. Sphenoid mucoceles, although rare, should be considered in patients with headache, visual disorders and eye paralysis. The differential diagnosis of lesions at skull base is made with other pathologies with a more reserved prognosis. Objectives: To report a case of large volume sphenoid mucocele, initially diagnosed as an inoperable tumor, evolving with facial paresthesia and visual loss due to resolution delay. Resumed report: 48-year-old female patient, with longstanding headache, underwent cranial CT during hospitalization for Covid-19 and an expansive lesion was seen at the skull base, suprasellar, compromising the cavernous sinus, measuring 53 mm in its longest axis, eroding the sellar floor and in close contact with optic chiasm. Referred to the otolaryngology for investigation, she presented with frontal headache, hypoesthesia of middle third of the left face, nasal obstruction on the left side and temporary left amaurosis evolving with left temporal hemianopia. The patient's nasal endoscopy revealed an expansive lesion medial to the middle turbinates, filling the left sphenoethmoidal recess. During the surgical approach, a large amount of purulent secretion was drained and the diagnosis of mucocele was confirmed. The patient got better of the temporal left hemianopia. Conclusion: The reported case became a surgical urgency due to impaired visual acuity. An earlier approach could avoid patient fatigue and decrease intraoperative risk. [ABSTRACT FROM AUTHOR]