We identified and treated a solid, growing fungal tumor mass in a patient with disseminated histoplasmosis. Although the most commonly reported intraocular lesions from disseminated histoplasmosis are areas of inactive chorioretinal scars or areas of localized subretinal neovascular membrane formation, a focus of active fungal growth needs to be ruled out in all such cases. When a solid tumor mass is identified, the most effective way of preserving vision is with systemic antifungal therapy.