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

Hasib Ahmadzai; Darryl Alan Raley; Lynette Masters; Mark Davies

doi:10.1093/jscr/rjt018

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

J Surg Case Rep. 2013 Apr 18;2013(4):rjt018. doi: 10.1093/jscr/rjt018.

Authors

Hasib Ahmadzai¹, Darryl Alan Raley², Lynette Masters³, Mark Davies⁴

Affiliations

¹ Faculty of Medicine, University of New South Wales (UNSW), Sydney, Australia Department of Neurology and Neurosurgery, St George Hospital, Kogarah, Australia h.ahmadzai@unswalumni.com.
² Department of Neurology and Neurosurgery, St George Hospital, Kogarah, Australia.
³ Department of Neuroradiology, Southern Radiology, Miranda, Australia Brain and Mind Research Institute, University of Sydney, Camperdown, Australia.
⁴ Faculty of Medicine, University of New South Wales (UNSW), Sydney, Australia Department of Neurology and Neurosurgery, St George Hospital, Kogarah, Australia.

Abstract

Sellar aspergillosis is a rare infection commonly mistaken for a pituitary tumour. We present a rare case of pituitary fossa Aspergillus fumigatus mycetoma in an immunocompetent 90-year-old female, who presented with headaches. Magnetic resonance imaging scans demonstrated an enhancing pituitary fossa mass that appeared to infiltrate the sphenoid sinus, suggestive of an invasive tumour. Stereotactic trans-sphenoidal resection confirmed localized A. fumigatus infection. The abscess was debrided and the dura was left intact. Her headaches resolved post-operatively and she was treated with voriconazole. This indicates that aspergilloma should be considered as a differential for an unexplained pituitary lesion even in elderly immunocompetent patients.

Publication types

Case Reports