Strohm M
Laryngol Rhinol Otol (Stuttg). 1982 Jan;61(1):48-51.
A man of 74 years of age, suffering from a left-sided ophthalmoplegia and a radiologically detected opacification of the sphenoid sinus with destruction of the bony roof of the sphenoid sinus, was operated on because a malignant tumor was suspected. A destruction of the bony walls of the sphenoid sinus was found. The histological examination of the "glue"-like "tumorous" material revealed an aspergillosis. The patient developed an aspesrgillus meningitis postoperatively. Intrathecally administered Amphotericin B led to an improvement of the meningitis, but caused a fatal renal failure. A review of the literature showed that only 7 cases of aspergillosis of the sphenoid sinus have been reported, 3 of which presented with a tumor-like destruction of the sinus. An aspergilloma of the sphenoid sinus is therefore a rare but important differential diagnosis in patients with a suspected malignancy of the infrasellar region.
一名74岁男性，患有左侧眼肌麻痹，影像学检查发现蝶窦混浊，蝶窦骨顶破坏，因怀疑患有恶性肿瘤而接受手术。术中发现蝶窦骨壁破坏。对“胶状”“肿瘤样”物质进行组织学检查，结果显示为曲霉菌病。患者术后发生曲霉菌性脑膜炎。鞘内注射两性霉素B使脑膜炎有所改善，但导致了致命的肾衰竭。文献回顾显示，仅报道了7例蝶窦曲霉菌病，其中3例表现为窦腔的肿瘤样破坏。因此，蝶窦曲菌球在疑似鞍下区域恶性肿瘤的患者中是一种罕见但重要的鉴别诊断。
