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Invasive sphenoid sinus aspergillosis mimicking sellar tumor: a report of 4 cases and systematic literature review
BACKGROUND: Invasive sphenoid sinus aspergillosis is a rare but life-threatening condition usually found in immunocompromised patients. When involving cavernous sinus and surrounding structures, patients are frequently misdiagnosed with a neoplasm or sellar abscess. Timely diagnosis and intervention...
Autores principales: | , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
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BioMed Central
2020
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Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7398181/ https://www.ncbi.nlm.nih.gov/pubmed/32922939 http://dx.doi.org/10.1186/s41016-020-00187-0 |
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author | Zhang, Hanwen Jiang, Nian Lin, Xuelei Wanggou, Siyi Olson, Jeffrey J. Li, Xuejun |
author_facet | Zhang, Hanwen Jiang, Nian Lin, Xuelei Wanggou, Siyi Olson, Jeffrey J. Li, Xuejun |
author_sort | Zhang, Hanwen |
collection | PubMed |
description | BACKGROUND: Invasive sphenoid sinus aspergillosis is a rare but life-threatening condition usually found in immunocompromised patients. When involving cavernous sinus and surrounding structures, patients are frequently misdiagnosed with a neoplasm or sellar abscess. Timely diagnosis and intervention are crucial to patients’ outcomes. The objective of this study is to review cases of invasive sphenoid sinus aspergillosis to describe disease manifestations, imaging features, treatment, and outcome. CASE PRESENTATION: We describe four patients with invasive sphenoid sinus aspergillosis misdiagnosed as sellar tumors preoperatively. The mass was completely removed in three patients and partially removed in one patient microscopically. Pathological examinations confirmed Aspergillus in all cases. All four patients received anti-fungal agents postoperatively. There was no recurrence at the time of each patient’s follow-up date. One patient with complete resection was lost to follow-up while the other three patients’ neurologic function improved. Additionally, we performed a systematic review regarding invasive sphenoid sinus aspergillosis of existing English literature. CONCLUSION: With regard to clinical symptoms, headache, vision impairment, and ophthalmoplegia were observed in over half of the patients in the literature. A sellar mass with bone destruction on CT and involvement of cavernous sinus is highly suggestive of invasive fungal sphenoid sinusitis. Immediate surgical removal of the lesion is recommended for invasive sphenoid sinus aspergillosis to preserve nerve function and increase the likelihood of survival. |
format | Online Article Text |
id | pubmed-7398181 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2020 |
publisher | BioMed Central |
record_format | MEDLINE/PubMed |
spelling | pubmed-73981812020-09-10 Invasive sphenoid sinus aspergillosis mimicking sellar tumor: a report of 4 cases and systematic literature review Zhang, Hanwen Jiang, Nian Lin, Xuelei Wanggou, Siyi Olson, Jeffrey J. Li, Xuejun Chin Neurosurg J Case Report BACKGROUND: Invasive sphenoid sinus aspergillosis is a rare but life-threatening condition usually found in immunocompromised patients. When involving cavernous sinus and surrounding structures, patients are frequently misdiagnosed with a neoplasm or sellar abscess. Timely diagnosis and intervention are crucial to patients’ outcomes. The objective of this study is to review cases of invasive sphenoid sinus aspergillosis to describe disease manifestations, imaging features, treatment, and outcome. CASE PRESENTATION: We describe four patients with invasive sphenoid sinus aspergillosis misdiagnosed as sellar tumors preoperatively. The mass was completely removed in three patients and partially removed in one patient microscopically. Pathological examinations confirmed Aspergillus in all cases. All four patients received anti-fungal agents postoperatively. There was no recurrence at the time of each patient’s follow-up date. One patient with complete resection was lost to follow-up while the other three patients’ neurologic function improved. Additionally, we performed a systematic review regarding invasive sphenoid sinus aspergillosis of existing English literature. CONCLUSION: With regard to clinical symptoms, headache, vision impairment, and ophthalmoplegia were observed in over half of the patients in the literature. A sellar mass with bone destruction on CT and involvement of cavernous sinus is highly suggestive of invasive fungal sphenoid sinusitis. Immediate surgical removal of the lesion is recommended for invasive sphenoid sinus aspergillosis to preserve nerve function and increase the likelihood of survival. BioMed Central 2020-04-09 /pmc/articles/PMC7398181/ /pubmed/32922939 http://dx.doi.org/10.1186/s41016-020-00187-0 Text en © The Author(s) 2020 Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data. |
spellingShingle | Case Report Zhang, Hanwen Jiang, Nian Lin, Xuelei Wanggou, Siyi Olson, Jeffrey J. Li, Xuejun Invasive sphenoid sinus aspergillosis mimicking sellar tumor: a report of 4 cases and systematic literature review |
title | Invasive sphenoid sinus aspergillosis mimicking sellar tumor: a report of 4 cases and systematic literature review |
title_full | Invasive sphenoid sinus aspergillosis mimicking sellar tumor: a report of 4 cases and systematic literature review |
title_fullStr | Invasive sphenoid sinus aspergillosis mimicking sellar tumor: a report of 4 cases and systematic literature review |
title_full_unstemmed | Invasive sphenoid sinus aspergillosis mimicking sellar tumor: a report of 4 cases and systematic literature review |
title_short | Invasive sphenoid sinus aspergillosis mimicking sellar tumor: a report of 4 cases and systematic literature review |
title_sort | invasive sphenoid sinus aspergillosis mimicking sellar tumor: a report of 4 cases and systematic literature review |
topic | Case Report |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7398181/ https://www.ncbi.nlm.nih.gov/pubmed/32922939 http://dx.doi.org/10.1186/s41016-020-00187-0 |
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