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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 ,
S K Kim ,
Y E Joo  and
S C Lim
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
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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.

Keywords

Fungus DiseaseMucoceleSphenoid Sinus

Information

Type
Clinical Records
Information
The Journal of Laryngology & Otology , Volume 126 , Issue 2 , February 2012 , pp. 210 - 213
Copyright
Copyright © JLO (1984) Limited 2011

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