Hasan Ibtisam, Smith Stephanie F, Hammond-Kenny Amy
Department of Medicine, West Suffolk Hospital, Bury St Edmunds IP33 2QZ, UK.
Department of General Surgery, West Suffolk Hospital, Bury St Edmunds IP33 2QZ, UK.
J Surg Case Rep. 2019 Apr 3;2019(4):rjz099. doi: 10.1093/jscr/rjz099. eCollection 2019 Apr.
Potts puffy tumour (PPT) is a subperiosteal abscess arising from frontal bone osteomyelitis. We present a case of a 75-year-old lady with headache and a forehead swelling who was initially treated for sinusitis and giant cell arteritis in a primary care setting, but failed to improve. Following clinical deterioration and further investigation, CT appearances were consistent with a diagnosis of PPT and an extra-axial collection. Needle decompression, frontal trephine and endoscopic frontal sinusotomy were performed and intraoperative swabs cultured PPT is an unusual clinical entity that benefits from prompt antibiotic and surgical management, and therefore early recognition is paramount. We highlight that PPT should be a differential diagnosis in all patients presenting with forehead or frontal swelling. Use of radiological imaging (CT/MRI) is necessary to not only confirm a diagnosis of PPT but to identify further intracranial complications, which can be life-threatening.
波特氏肿（PPT）是一种由额骨骨髓炎引起的骨膜下脓肿。我们报告一例75岁女性病例，该患者有头痛和前额肿胀症状，最初在基层医疗环境中被诊断为鼻窦炎和巨细胞动脉炎并接受治疗，但病情未改善。随着临床病情恶化并进一步检查，CT表现符合PPT及轴外积液的诊断。进行了针吸减压、额骨环钻术和内镜下额窦切开术，术中拭子培养结果显示……PPT是一种不常见的临床病症，及时的抗生素和手术治疗对其有益，因此早期识别至关重要。我们强调，对于所有出现前额或额部肿胀的患者，PPT都应作为鉴别诊断之一。使用放射影像学检查（CT/MRI）不仅对于确诊PPT是必要的，而且对于识别可能危及生命的进一步颅内并发症也是必要的。
