Potts puffy tumour: a rare but important diagnosis. Issue 4 (3rd April 2019)

• Record Type: Journal Article
• Authors: Hasan, Ibtisam; Smith, Stephanie F; Hammond-Kenny, Amy
• Is Part Of: Journal of surgical case reports. Volume 2019:Issue 4(2019)
• Publication Date: 2019-04-03
• Subjects: Surgery -- Periodicals; Surgery -- Case studies -- Periodicals; 617.005
• DOI: 10.1093/jscr/rjz099
• Languages: English
• ISSNs: 2042-8812

Abstract

Abstract: 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 Streptococcus constellatus 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.