Sphenoid sinus aspergillosis simulating pituitary tumor in immunocompetent patient

An unusual case of a pituitary fossa aspergilloma in an immunocompetent patient mimicking infiltrative tumour

“…However, unlike previous cases, the mycetoma in this patient did not demonstrate a rim of peripheral ring enhancement [1–3]. Other important features of pituitary mycetomas on CT scans include mucoperiosteal thickening, bony erosion and calcification within the lesion [4]. These imaging features help in distinguishing these lesions from pituitary neoplasms.…”

“…Specific radiological features evident in this case include iso-to-hypointense signals on T 1 -weighted sequences, heterogeneous enhancement on post-gadolinium T 1 -weighted sequences and hypointensity on T 2 -weighted images [3, 4]. Hypointensity on T 2 -weighted images is a key feature of an aspergilloma, indicating high concentrations of ferromagnetic elements including iron, zinc, magnesium and manganese, critical for fungal amino-acid metabolism [2].…”

Sphenoid sinus aspergilloma in trans-sphenoidal surgery for pituitary adenomas

“…The first two categories are considered invasive and include a fulminant and indolent form. The other two categories are considered non-invasive and include a mycetoma (aspergilloma) and allergic Aspergillus sinusitis [5,7,14,20,27].…”

Primary Aspergillus Sellar Abscess Simulating Pituitary Tumor in Immunocompetent Patient

“…11,12 However, recently, good result was reported to be achieved without antifungal treatment for noninvasive aspergillosis. 13 Historically, patients with aspergillosis infection have been treated with amphotericin B or combined therapy with amphotericin B and flucytosine or itraconazole. The superiority of voriconazole and caspofungin over amphotericin B for aspergillosis infection in response rate, survival rate, and safety has now been demonstrated in a large randomized study.…”