title: Allergic fungal rhinosinusitis infiltrating anterior skull base and clivus.
abstract: Bone erosion and skull base invasion are often suggestive of a malignant mass in paranasal and nasal cavities. Nevertheless, forms of chronic rhinosinusitis, such as allergic fungal rhinosinusitis (AFRS), could mimic malignant features. Here, we report AFRS patient with orbital, anterior cranial fossa, Turkish saddle and clivus erosion. A 48-year-old Caucasian female with history of drug-resistant headache, nasal obstruction and anosmia was referred to our institution. Imaging showed hyperdense featureless tissue with signs of medial orbital wall, cribiform lamina and clivus erosions and encasement of right internal carotid artery. Massive amounts of thick and grayish mucoid material were evacuated during surgery. In case of bony erosion, malignancy should always be excluded. Often the correct diagnosis will be obtained only by operative specimens. AFRS could usually be managed endoscopically. Appropriate medical management of the AFRS should be administered in order to prevent relapses.
authors: Academic Clinic of Otolaryngology-Head and Neck Surgery, University of Florence, Florence, Italy.
authors: Giuseppe
authors: G
authors: Meccariello
authors: Alberto
authors: A
authors: Deganello
authors: Giuditta
authors: G
authors: Mannelli
authors: Giacomo
authors: G
authors: Bianco
authors: Franco
authors: F
authors: Ammannati
authors: Christos
authors: C
authors: Georgalas
authors: Oreste
authors: O
authors: Gallo
mesh_terms: D003388:Cranial Fossa, Posterior / Q000382:microbiology; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D008875:Middle Aged; D009078:Mucocele / Q000150:complications / Q000175:diagnosis*; D009298:Nasal Polyps / Q000150:complications; D065631:Rhinitis, Allergic; D012221:Rhinitis, Allergic, Perennial / Q000150:complications / Q000175:diagnosis*; D012852:Sinusitis / Q000150:complications / Q000175:diagnosis*; D019291:Skull Base / Q000382:microbiology; D019292:Skull Base Neoplasms / Q000175:diagnosis*