Primary aspergillosis of the sphenoid sinus with pituitary invasion - A rare differential diagnosis of sellar lesions

Research output: Contribution to journalReview articleContributedpeer-review

Contributors

  • T. Pinzer - , Department of Neurosurgery, University Hospital Carl Gustav Carus Dresden (Author)
  • M. Reiß - , Elblandklinikum Meißen-Radebeul (Author)
  • H. Bourquain - , University Hospital Carl Gustav Carus Dresden, Institute and Polyclinic of Diagnostic and Interventional Radiology (Author)
  • K. G. Krishnan - , University Hospital Carl Gustav Carus Dresden, Department of Neurosurgery (Author)
  • G. Schackert - , University Hospital Carl Gustav Carus Dresden, Department of Neurosurgery (Author)

Abstract

Aspergillosis belongs to the group of mycotic diseases of paranasal sinuses. The invasive forms, and particularly the fulminant forms, are potentially fatal. Isolated aspergillosis of the sphenoid sinus or the clivus is a difficult diagnosis, since the often misleading clinical manifestations of this rare disease develop late. These patients become apparent by neurological signs such as cavernous sinus syndrome, pseudotumor of the pituitary or the orbit. Diagnosis is often made intra-operatively or on histological examination. We report a case of invasive aspergillosis uniquely involving the sellar area revealed by clinical features suggesting a pseudotumor of the pituitary. Although such lesions are almost always seen in immune suppressed subjects, in our case, the patient was immune competent and had no past history of sinusitis. The question of whether, and when to perform limited or extensive surgery remains an issue for discussion, owing to the rarity of this disease honed by lack of experience. It depends on several factors: the kind of disease, the immunity, the subtype of invasive fungal sinusitis and the degree of tissue invasion.

Details

Original languageEnglish
Pages (from-to)1085-1090
Number of pages6
JournalActa Neurochirurgica
Volume148
Issue number10
Publication statusPublished - Oct 2006
Peer-reviewedYes

External IDs

Scopus 33748993969
PubMed 16855812

Keywords

Keywords

  • Aspergillosis, Diseases of the paranasal sinuses, Pituitary adenoma, Skull base