Fungal sinusitis with cerebral invasion

Case contributed by Dr Ahmed Abd Rabou

Presentation

Patient with recurrent fungal sinusitis underwent previous sinus surgeries and now complains of left proptosis, headache, confusion and disorientation

Patient Data

Age: 25 years
Gender: Male
Modality: MRI

Mucoperiosteal thickening seen involving the left frontal, maxillary, ethmoidal and sphenoid sinuses which exhibits intermediate T1 and low T2 signal intensity, avid enhancement after contrast administration and with intraorbital infiltration at the medial side of left orbit and intracranial invasion via the cribriform plate. The left gyrus rectus shows a focal area of abnormal signal surrounded by edema and enhances after contrast administration.

Case Discussion

Chronic invasive fungal sinusitis that infiltrates the orbit through lamina papyracea and infiltrates the olfactory gyrus through the cribriform plate. The affected olfactory gyrus shows abnormal signal intensity, abnormal enhancement and surrounded by edema. Biopsy revealed Aspergillus flavus.

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Case Information

rID: 39810
Case created: 21st Sep 2015
Last edited: 29th May 2016
Inclusion in quiz mode: Included

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