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Allergic fungal rhinosinusitis infiltrating anterior skull base and clivus

Giuseppe Meccariello1, Alberto Deganello, Giuditta Mannelli

  • 1Academic Clinic of Otolaryngology-Head and Neck Surgery, University of Florence, Florence, Italy.

Auris, Nasus, Larynx
|July 27, 2012
PubMed

Insights

Allergic fungal rhinosinusitis (AFRS) can mimic malignant tumors, causing extensive bone erosion in the skull base and orbits. Early diagnosis via surgical specimens is crucial for effective endoscopic management and preventing recurrence.

Area of Science:

  • Otolaryngology
  • Pathology
  • Radiology

Background:

  • Malignant masses in paranasal sinuses often present with bone erosion and skull base invasion.
  • Differentiating these from benign conditions like chronic rhinosinusitis can be challenging.

Observation:

  • A case of allergic fungal rhinosinusitis (AFRS) mimicking malignancy is presented.
  • The patient exhibited orbital, anterior cranial fossa, Turkish saddle, and clivus erosion.
  • Imaging revealed tissue encasing the internal carotid artery.

Findings:

  • Surgical evacuation yielded thick, mucoid material characteristic of AFRS.
  • Histopathological examination of operative specimens confirmed the diagnosis.
  • Malignancy was excluded despite extensive bony erosion.

Implications:

  • AFRS can present with aggressive features, necessitating exclusion of malignancy in cases of bone erosion.
  • Endoscopic surgery is a viable treatment option for AFRS.
  • Comprehensive medical management is essential to prevent AFRS relapses.

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