A recent study suggests that a high index of suspicion for Porter’s floating tumor (PPT), a rare complication of frontal sinusitis, should be raised in adolescents with chronic headaches or forehead swelling.
Contrast-enhanced computed tomography (CT) can be used for initial evaluation, but if intracranial involvement is suspected, magnetic resonance imaging (MRI) must be performed to determine whether intracranial intervention is necessary, the researchers said.
PPT was reported in a series of 10 pediatric patients aged 9–17 years attending two tertiary care pediatric hospitals in central Israel between January 2018 and August 2022. The researchers then reviewed the published literature on pediatric PPT.
Headache (10 cases) was the most common clinical manifestation among patients, followed by forehead swelling (6 cases) and fever (5 cases). The duration of symptoms before admission ranged from 1 to 28 days (median 10 days).
Clinicians diagnosed PPT via imaging an average of 1 day after admission. All 10 patients underwent CT examinations, and 6 children also underwent MRI examinations. Intracranial complications occur in 70% of patients. All children were treated with systemic antibiotics and underwent surgical intervention.
The most common pathogenic bacteria are Streptococcus constellatus group. All patients recovered without any serious events.
“In most cases, with appropriate antibiotic treatment and surgical intervention, full recovery can be expected,” the researchers said.