MYCOLab Ai Logo - gold and army green

Fungal Sinusitis Spreading to the Sellar Region Mimicking a Pituitary Tumor: Case Report and Literature Review

Summary

A 56-year-old woman was found to have a large mass in her sinus cavity that had eroded bone and spread to the area around her pituitary gland, mimicking a pituitary tumor. Through surgery and pathological examination, doctors discovered it was actually a fungal infection (fungus ball) rather than a tumor. This case report reviews 67 similar patients from medical literature to help doctors better recognize and treat these rare fungal infections that can threaten vision and endocrine function.

Background

Chronic fungal sinusitis can cause bone erosion and extend to the sellar region, often being misdiagnosed as pituitary tumors or malignancies. Non-invasive fungal sinusitis forms like fungal balls and allergic fungal sinusitis typically occur in immunocompetent individuals and are generally indolent, though they can occasionally progress to more aggressive disease with intracranial extension.

Objective

To report a case of sphenoid fungal sinusitis with sellar extension mimicking a pituitary tumor and to conduct a systematic literature review of similar cases to compare clinical presentations, risk factors, fungal types, imaging findings, and treatment outcomes.

Results

The 56-year-old immunocompetent female patient presented with headache, visual disturbances, and bitemporal hemianopia with a giant sellar mass and normal pituitary function. Literature review of 67 patients (mean age 49.6 years, 52% immunocompetent) showed headache (73.1%) and visual complaints (71.7%) as most common symptoms, with Aspergillus being the most frequent fungus (71.6%). Surgery was performed in 92.5% of cases with 67.2% cure rate and 10.4% mortality.

Conclusion

Early recognition of fungal involvement through a multidisciplinary approach is essential for accurate diagnosis and effective treatment of fungal sinusitis with sellar extension. Surgery remains the gold standard for fungal balls, though the optimal management of aggressive allergic fungal sinusitis requires further guideline development and multidisciplinary collaboration.
  • Published in:Journal of Fungi,
  • Study Type:Case Report and Literature Review,
  • Source: PMID: 40137270, DOI: 10.3390/jof11030233
Scroll to Top