Cranial aspergilloma masquerading as meningioma
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Published on: July 5, 2021
Ritu Verma1, Prabhat Singh, Achal Kumar
1Department of Pathology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, Uttar Pradesh, India.
Abstract:
Cranial aspergillosis may present as meningitis, cerebral abscess, cerebral infarcts/haemorrhages or extra-axial mass. Extra-axial cranial aspergilloma may mimic meningioma owing to mass-like characteristics and intense contrast enhancement on MRI there by delaying the diagnosis and further worsening the already bad prognosis in these patients. We present a 45-year-old gentleman who presented with signs of raised intracranial hypertension, secondary optic atrophy and a contrast-enhancing mass arising from the planum sphenoidale. Postoperatively, mass was diagnosed as aspergilloma on histopathology and culture. Despite antifungal treatment, patient could not be saved due to large artery infarcts in the immediate postoperative period. We discuss the clinical and MRI features that could help to have sufficient and early suspicion of fungal aetiology in these patients.
Insights
Cranial aspergillosis, a fungal infection, can mimic tumors on MRI, delaying diagnosis. Early recognition of specific clinical and imaging features is crucial for better patient outcomes in fungal brain infections.
Area of Science:
- Neurology
- Mycology
- Radiology
Background:
- Cranial aspergillosis presents with diverse neurological symptoms, including meningitis and brain abscesses.
- Extra-axial cranial aspergilloma can resemble meningioma on MRI, potentially leading to diagnostic delays.
- Delayed diagnosis of fungal brain infections worsens patient prognosis.
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