Aggressive fungal sinusitis

Case contributed by Fakhry Mahmoud Ebouda
Diagnosis almost certain


Chronic headache and nasal obstruction.

Patient Data

Age: 10 years
Gender: Female

The right maxillary antrum, ethmoid air cells and corresponding nasal fossa are expanded and show rarified outlines. They are the seat and totally occupied by isodense soft tissue mass with intervening hyperdense streaks and septae. They show no significant enhancement in the post contrast series.

The lesion causes expansion of the surrounding bones with bony remodeling, occluding of the right osteomeatal complex. The lesion erodes the ethmoidal air cells and break through the right lamina papyracea with right intraorbital extraconal extension. It displaces the right medial rectus and abuts the adjacent surface of the globe. Thinning and rarefaction of floor of the right compartment of the anterior cranial fossa and cribriform plate of ethmoid.

The lesions with hyperdense colonies extends posteriorly occupying both compartments of the sphenoidal sinuses, right nasal choana and protrudes into related part of the nasopharynx.

Case Discussion

Aggressive right sided sinonasal polypoidal fungal infection with right orbital extension.

Thanks for Fadwa Fakhry for helping me in case preparation.

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