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Parasellar Aspergillus granuloma extending from the sphenoid sinus: report of two cases
H Kurita1, Y Shiokawa, K Furuya
1Department of Neurosurgery, Fuji Brain Institute and Hospital, Shizuoka, Japan.
Background:
Sphenoid sinus aspergillosis is a rare disease known to show an aggressive course with high mortality. Early diagnosis, though difficult, is required to prevent lethal fungal meningoencephalitis.
Case Report:
We describe two cases of parasellar Aspergillus granuloma extending from the sphenoid sinus clinically indistinguishable from intracranial neoplasms. In the first patient, the fungus colony was visualized by computed tomography (CT) and magnetic resonance imaging (MRI) as a calcified concretion and total removal was curative. In the second patient, partial removal and subsequent antifungal therapy had minimal effect.
Conclusions:
The prognosis of the patients with this disease depends on prompt surgical treatment before intradural invasion occurs, and CT and MRI are useful diagnostic maneuvers for detecting calcified Aspergillus colonies.
Insights
Sphenoid sinus aspergillosis is a rare, aggressive fungal infection. Early diagnosis with CT and MRI is crucial for surgical treatment and preventing deadly meningoencephalitis.
Area of Science:
- Mycology
- Neurosurgery
- Radiology
Background:
- Sphenoid sinus aspergillosis is a rare fungal infection.
- It presents an aggressive clinical course with high mortality.
- Early diagnosis is critical to prevent fatal fungal meningoencephalitis.
Observation:
- Two cases of parasellar Aspergillus granuloma originating from the sphenoid sinus are presented.
- These granulomas mimicked intracranial neoplasms.
- Imaging revealed calcified fungal colonies in one patient.
Findings:
- Computed tomography (CT) and magnetic resonance imaging (MRI) visualized calcified Aspergillus colonies.
- Complete surgical removal was curative in the first patient.
- Partial removal and antifungal therapy were ineffective in the second patient.
Implications:
- Prompt surgical intervention before intradural invasion is key to patient prognosis.
- CT and MRI are valuable diagnostic tools for identifying calcified Aspergillus colonies.
- This highlights the importance of considering fungal infections in parasellar masses.