Presentation
The patient presents with a headache, left-side weakness, and right-eye proptosis.
Patient Data
CT shows a homogenous, well-defined mass invading the right anterior skull base, ethmoid sinus, and orbital medial wall, causing proptosis of the right eye; meanwhile, the mass causes severe midline shift and oedema in the right cerebral hemisphere.
Case Discussion
The post-operative histopathology result is a cerebral fungal infection - aspergilloma. Cerebral invasive aspergilloma is associated with the highest mortality. The incidence of cerebral invasive aspergilloma is difficult to determine because the diagnosis is often unsuspected, but it has been estimated to occur in between 10% and 20% of all cases of invasive aspergillosis. It usually occurs in immunocompromised patients.
Contributors to this case: Dr. Gobran Taha Alfotih (neurosurgeon), Dr. Ali Shraf Al-dine (neurosurgeon), Dr. Fahd Suhail (radiology specialist), and Dr. Abdalaziz Hanash (radiology specialist).
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