Kurita H, Shiokawa Y, Furuya K, Segawa H, Sano K
Department of Neurosurgery, Fuji Brain Institute and Hospital, Shizuoka, Japan.
Surg Neurol. 1995 Nov;44(5):489-94. doi: 10.1016/0090-3019(95)00208-1.
Sphenoid sinus aspergillosis is a rare disease known to show an aggressive course with high mortality. Early diagnosis, though difficult, is required to prevent lethal fungal meningoencephalitis.
We describe two cases of parasellar Aspergillus granuloma extending from the sphenoid sinus clinically indistinguishable from intracranial neoplasms. In the first patient, the fungus colony was visualized by computed tomography (CT) and magnetic resonance imaging (MRI) as a calcified concretion and total removal was curative. In the second patient, partial removal and subsequent antifungal therapy had minimal effect.
The prognosis of the patients with this disease depends on prompt surgical treatment before intradural invasion occurs, and CT and MRI are useful diagnostic maneuvers for detecting calcified Aspergillus colonies.
蝶窦曲霉菌病是一种罕见疾病，已知病程进展迅速，死亡率高。尽管早期诊断困难，但为预防致死性真菌性脑膜脑炎仍需进行早期诊断。
我们描述了两例鞍旁曲霉菌肉芽肿病例，病变从蝶窦延伸，临床上与颅内肿瘤难以区分。在首例患者中，通过计算机断层扫描（CT）和磁共振成像（MRI）将真菌菌落显示为钙化性硬结，完整切除可治愈。在第二例患者中，部分切除及后续抗真菌治疗效果甚微。
本病患者的预后取决于在硬脑膜侵犯发生之前及时进行手术治疗，CT和MRI是检测钙化曲霉菌落的有用诊断手段。
