Sphenoid sinus aspergilloma in trans-sphenoidal surgery for pituitary adenomas

Acta Neurochir (Wien). 2015 Sep;157(8):1345-51; discussion 1351. doi: 10.1007/s00701-015-2485-6. Epub 2015 Jul 2.

Abstract

Background: Simultaneous appearance of sphenoid sinus aspergilloma and pituitary adenoma is a very rare finding.

Methods: Retrospective analysis of patients with sellar and sphenoid sinus mass lesions who underwent trans-sphenoidal surgery was performed. Demographic data, medical history, predisposing factors, clinical picture, neurological status and radiological findings were reviewed. All patients underwent a trans-sphenoidal microsurgical treatment, and acquired specimens underwent both histopathological and microbiological analysis.

Results: Sphenoid sinus aspergilloma was encountered in seven patients. Three patients had an isolated sphenoid sinus aspergilloma and four patients with pituitary macroadenoma had a sphenoid aspergilloma as an incidental finding.

Conclusions: Sphenoid sinus aspergilloma can be found during trans-sphenoidal surgery for pituitary adenomas. Sphenoid sinus extirpation followed by adenomectomy is the treatment of choice unless invasive aspergilloma is encountered requiring additional antifungal therapy.

Publication types

  • Case Reports

MeSH terms

  • Adenoma / surgery*
  • Aged
  • Aged, 80 and over
  • Antifungal Agents / therapeutic use
  • Aspergillosis / diagnosis*
  • Aspergillosis / drug therapy
  • Aspergillosis / surgery
  • Aspergillus / isolation & purification*
  • Comorbidity
  • Female
  • Humans
  • Incidental Findings
  • Male
  • Middle Aged
  • Pituitary Neoplasms / surgery*
  • Retrospective Studies
  • Sphenoid Bone / surgery
  • Sphenoid Sinus / microbiology*
  • Sphenoid Sinus / surgery
  • Treatment Outcome

Substances

  • Antifungal Agents