Rhinocerebral aspergillosis

Abstract

A 27-year-old man presented to our hospital with a 4-month history of bilateral frontal headache, irritability, frontal lobe signs, bilateral proptosis, and nasal obstruction. He had no other signs or symptoms of a systemic illness. Rhinoscopy showed a soft tissue mass obstructing both nasal airways. A CT scan of his head showed hyperdense lesions involving both the paranasal sinuses (figure), with expansions into the frontal interdiploë spaces, and some calcification (figure). An MRI scan of the brain showed a soft tissue mass extending along the anterior cranial fossa floor up to the sellar and parasellar regions (figure). Endoscopic biopsy was inconclusive; however, because of raised intracranial pressure, the patient was taken to surgery for craniotomy and excision of the lesion.