Initially it was thought that his right upper limb weakness was due to a stroke, however both a CT brain and a subsequent MRI brain were normal. The routine CXR revealed an unexpected right apical mass and CT demonstrated the typical bird’s nest appearance. Invasion of the spine and chest wall in the region of the brachial plexus satisfactorily explains his right upper limb weakness. The patient was found to have uncontrolled diabetes mellitus (HbA1c-14%), a risk factor for mucormycosis due to impaired immune function.
Co-authors: Dr Neeraj Bharti (internal medicine) and Dr Saket Ballabh (radiodiagnosis)