title: Fungus ball within a mucocele of the sphenoid sinus and infratemporal fossa: case report with radiological findings.
abstract: OBJECTIVE
  We report an extremely rare case of a fungus ball within a mucocele of the sphenoid sinus and infratemporal fossa.
  
  
  METHODS
  A 62-year-old woman was referred for evaluation of a mass lesion in the left sphenoid sinus and infratemporal fossa. Endoscopic examination of the nasal cavity was unremarkable. Computed tomography showed a non-enhancing, expansile mass with calcifications in the sphenoid and infratemporal fossa; T2-weighted magnetic resonance imaging revealed marked hypointense signals within the sphenoid sinus mass, with an intermediate signal intensity. A presumptive diagnosis of a mucocele was made. During surgery, a profuse amount of yellow fluid was drained from the mucocele. Clay-like material was noted within the mucocele, corresponding to the hypointense magnetic resonance imaging signals; this was identified as aspergillus on histopathological examination. Radiological findings for a fungus ball within a mucocele can be similar to those for allergic fungal sinusitis, which shows mixed low and high attenuation on computed tomography and low-signal intensity on T2-weighted magnetic resonance imaging, within an expansile, cystic lesion.
  
  
  CONCLUSIONS
  Although an association between a fungus ball and a mucocele is rare in the paranasal sinuses, this disease entity should be considered in the differential diagnosis of expansile, cystic sinus lesions.
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, Chonnam National University Medical School and Chonnam National University Hwasun Hospital, Jeonnam, South Korea.
authors.forename: D H
authors.initials: DH
authors.lastname: Lee
authors.forename: S K
authors.initials: SK
authors.lastname: Kim
authors.forename: Y E
authors.initials: YE
authors.lastname: Joo
authors.forename: S C
authors.initials: SC
authors.lastname: Lim
mesh_terms: D001228:Aspergillosis / Q000150:complications / Q000000981:diagnostic imaging* / Q000473:pathology; D004322:Drainage; D004724:Endoscopy; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D008875:Middle Aged; D009078:Mucocele / Q000150:complications / Q000000981:diagnostic imaging* / Q000382:microbiology / Q000473:pathology; D010254:Paranasal Sinus Diseases / Q000000981:diagnostic imaging* / Q000382:microbiology / Q000473:pathology; D013101:Sphenoid Sinus; D013701:Temporal Bone; D014057:Tomography, X-Ray Computed