title: Invasive sphenocavernous aspergilloma complicating an operated case of acromegaly.
abstract: There is a surge in fungal infections of the central nervous system due to an increase in the incidence of immunocompromised state and widespread use of antimicrobials. Despite myriad clinical presentations and skull base syndromes associated with Aspergillus infections, aspergilloma in the sella is relatively rare. We report a rare case of aspergilloma of the sella and parasellar region in a patient operated for acromegaly. A 30-year-old diabetic patient underwent two surgeries for a growth hormone-secreting pituitary adenoma, which included a transsphenoidal approach. During his last admission, magnetic resonance imaging revealed a heterogeneous mass in the sella, suprasellar region, sphenoid sinus, and cavernous sinus with multiple areas of necrosis. His presentation, surgical treatment, and response to antifungal therapy are discussed. The role of prior surgery and related comorbidities in developing the invasive granuloma are highlighted.
authors: Department of Neurosurgery, Sri Sathya Sai Institute of Higher Medical Sciences, EPIP Area, Karnataka State, Bangalore, India.
authors: Sunil V
authors: SV
authors: Furtado
authors: Prasanna K
authors: PK
authors: Venkatesh
authors: Nandita
authors: N
authors: Ghosal
authors: Alangar S
authors: AS
authors: Hegde
keywords: Acromegaly; Aspergillus; amphotericin; cavernous sinus; fungal infections; sella; surgery
references: Neurol India. 2008 Apr-Jun;56(2):186-8
references: 18688146
references: Acta Neurochir (Wien). 2004 May;146(5):521-4
references: 15118891
references: Neuroimaging Clin N Am. 2000 May;10(2):409-25
references: 10775959
references: Surg Neurol. 2001 Sep;56(3):195-200
references: 11597652
references: Neurol India. 2007 Jul-Sep;55(3):221-5
references: 17921650
references: Australas Radiol. 1998 May;42(2):128-9
references: 9599827
references: Pathol Oncol Res. 2001;7(1):74-6
references: 11349226
references: Braz J Infect Dis. 2008 Aug;12(4):349-51
references: 19030740
references: Neurol Med Chir (Tokyo). 1996 Oct;36(10):733-6
references: 8937097
references: Neurol India. 2007 Jul-Sep;55(3):274-81
references: 17921657
references: Neurol India. 2007 Jul-Sep;55(3):191-7
references: 17921647
references: J Neurosurg. 1981 Jun;54(6):839-41
references: 7241195
references: Surg Neurol. 2005 Mar;63(3):254-60; discussion 260
references: 15734518
references: Pituitary. 2004;7(2):103-6
references: 15761659