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Fungus ball within a mucocele of the sphenoid sinus and infratemporal fossa: case report with radiological findings

Published online by Cambridge University Press:  13 September 2011

D H Lee
Affiliation:
Department of Otolaryngology-Head and Neck Surgery, Research Institute of Medical Sciences, Chonnam National University Medical School and Chonnam National University Hwasun Hospital, Jeonnam, South Korea
S K Kim
Affiliation:
Department of Radiology, Research Institute of Medical Sciences, Chonnam National University Medical School and Chonnam National University Hwasun Hospital, Jeonnam, South Korea
Y E Joo
Affiliation:
Research Institute of Medical Sciences, Chonnam National University Medical School and Chonnam National University Hwasun Hospital, Jeonnam, South Korea
S C Lim*
Affiliation:
Department of Otolaryngology-Head and Neck Surgery, Research Institute of Medical Sciences, Chonnam National University Medical School and Chonnam National University Hwasun Hospital, Jeonnam, South Korea
*
Address for correspondence: Dr Sang Chul Lim, Department of Otolaryngology-Head and Neck Surgery, Chonnam National University Medical School, 8 Hack-dong, Dong-gu, Gwangju, 501-190South Korea Fax: +82 62 226 6369 E-mail: limsc@chonnam.ac.kr

Abstract

Objective:

We report an extremely rare case of a fungus ball within a mucocele of the sphenoid sinus and infratemporal fossa.

Case report:

A 62-year-old woman was referred for evaluation of a mass lesion in the left sphenoid sinus and infratemporal fossa. Endoscopic examination of the nasal cavity was unremarkable. Computed tomography showed a non-enhancing, expansile mass with calcifications in the sphenoid and infratemporal fossa; T2-weighted magnetic resonance imaging revealed marked hypointense signals within the sphenoid sinus mass, with an intermediate signal intensity. A presumptive diagnosis of a mucocele was made. During surgery, a profuse amount of yellow fluid was drained from the mucocele. Clay-like material was noted within the mucocele, corresponding to the hypointense magnetic resonance imaging signals; this was identified as aspergillus on histopathological examination. Radiological findings for a fungus ball within a mucocele can be similar to those for allergic fungal sinusitis, which shows mixed low and high attenuation on computed tomography and low-signal intensity on T2-weighted magnetic resonance imaging, within an expansile, cystic lesion.

Conclusion:

Although an association between a fungus ball and a mucocele is rare in the paranasal sinuses, this disease entity should be considered in the differential diagnosis of expansile, cystic sinus lesions.

Type
Clinical Records
Copyright
Copyright © JLO (1984) Limited 2011

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