Ota Ryo, Katada Akihiro, Bandoh Nobuyuki, Takahara Miki, Kishibe Kan, Hayashi Tatsuya, Harabuchi Yasuaki
Department of Otolaryngology-Head and Neck Surgery, Asahikawa Medical College, 2-1-1-1 Midorigaoka Higashi, Asahikawa, Hokkaido, Japan.
Auris Nasus Larynx. 2010 Apr;37(2):250-4. doi: 10.1016/j.anl.2009.06.003. Epub 2009 Aug 28.
Invasive paranasal aspergillosis has been previously reported, but there have been no case reports of non-invasive paranasal aspergillosis that progressed to the invasive form during follow-up. A case of non-invasive aspergillosis of the maxillary sinus that appeared to become invasive during 5-year follow-up is reported. The patient was diagnosed as having non-invasive aspergillosis at the first visit because CT images revealed only mucosal thickening and calcifications in the right maxillary sinus. Five years later, CT images showed an invasive mass lesion in the orbit and large bone destruction of the posterior wall of the maxillary sinus. The patient was rescued by total removal of the orbital contents with zygomatic ostectomy followed by appropriate antifungal chemotherapy irrespective of residual tissue invasion. We would propose that appropriate surgical treatment and antifungal agents are necessary to improve the prognosis of invasive aspergillosis.
侵袭性鼻旁曲霉病此前已有报道，但尚无关于非侵袭性鼻旁曲霉病在随访期间进展为侵袭性形式的病例报告。本文报告了1例上颌窦非侵袭性曲霉病，该病例在5年随访期间似乎发展为侵袭性。患者初诊时被诊断为非侵袭性曲霉病，因为CT图像仅显示右侧上颌窦黏膜增厚和钙化。5年后，CT图像显示眼眶内有侵袭性肿块病变，上颌窦后壁有大面积骨质破坏。患者接受了眶内容物全切术并颧骨切除术，随后进行了适当的抗真菌化疗，无论是否存在残留组织侵袭。我们建议，适当的手术治疗和抗真菌药物对于改善侵袭性曲霉病的预后是必要的。
