Presentation
The patient presents with chronic headache, weakness on the left side, and proptosis of the right eye.
Patient Data
There is a large extra-axial mass lesion in the right anterior frontal region with a cystic component at its posterior aspect. This lesion is associated with surrounding vasogenic edema, exerting a mass effect and compressing the right lateral ventricle, leading to an 8 mm midline shift to the left side.
Additionally, there are patchy intra-axial enhanced lesions in the right frontoparietal lobes. The lesion encases the cavernous part of the right internal carotid artery (ICA), the M1 segment of the right middle cerebral artery (MCA), and extends to the right orbital apex, including the optic nerve and chiasm.
The mass also destructs the frontal sinus, filling it, reaching the sphenoid sinuses, right ethmoid air cells, and the medial aspect of the right orbital cavity, encasing the right superior oblique and right medial rectus muscles, leading to secondary proptosis.
There is unilateral left ventricle hydrocephalus with mild permeation. The mass exhibits isointensity in T1, hypointensity in T2 and FLAIR, and heterogeneous enhancement in the post-contrast study.
Case Discussion
Our patient underwent a craniotomy, and the post-operative histopathology results indicate a cerebral fungal infection - specifically, aspergilloma.
Cerebral invasive aspergilloma is associated with the highest mortality rates and typically occurs in immunocompromised patients.
Contributors to this case include Dr. Abdulaziz Hanash (radiology specialist), Dr. Gobran Taha Alfotih (neurosurgeon), and Dr. Ali Shraf Al-dine (neurosurgeon).
Unable to process the form. Check for errors and try again.