PMC7398181_01
Case 1: a 69-year-old man. a CT image showing bone destruction in the sphenoid sinus and clival region. b MRI showing an intrasellar mass with hypointense signal on T2WI. c MRI showing an intrasellar mass with isointense signal on T1WI. d Enhanced MRI showing the lesions with heterogeneous enhancement in sphenoid, bilateral cavernous sinuses, ethmoid sinuses, and maxillary sinus. e Photomicrograph of the surgical specimen revealing the histologic findings of septate, clustered aspergillus hyphae. f MRI showing the resection of the mass
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Fig1
Bone destruction was observed in both regions (Fig. 1a). T2-weighted images (T2WI) in the lesions and an isointense signal on T1 weighted images (T2WI) with heterogeneous gadolinium-enhancement in the sphenoid sinus, both cavernous sinuses, bilateral ethmoid sinuses, and maxillary sinus (Fig. 1b-d). This patient underwent trans-sphenoidal lesion debridement. A biopsy was performed immediately and histopathology examination revealed Aspergillus species (Fig. 1e). Post-operative images indicated the resection of the mass (Fig. 1f).
PMC7398181_02
Case 2: a 52-year-old man. a CT image showing bone destruction in the sphenoid sinus and cavernous sinus region. b MRI showing an intrasellar mass with hyperintense signal extending bilaterally into the cavernous sinus on T2WI. c MRI showing an intrasellar mass with hyperintense signal on T1WI. d Enhanced MRI showing the lesions ring enhancement. e Photomicrograph of the surgical specimen revealing the histologic findings of septate, clustered aspergillus hyphae. f MRI showing the resection of the mass
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Fig2
CT scan showed a mass in sphenoid sinus and cavernous sinus with bone destruction (Fig. 2a). The lesion extended bilaterally into the cavernous sinus and formed a 12 x 11 mm mass (Fig. 2b-d). The patient underwent a trans-sphenoidal mass excision and debridement. The lesion was solid and cystic with yellow-brown fluid and a gray wax-like solid component. A biopsy was performed immediately and histopathologic examination revealed Aspergillus species (Fig. 2e). Post-operative images indicated the resection of the mass (Fig. 2f).
PMC7398181_03
Case 3: a 64-year-old man. a CT image showing bone destruction in the left wall of the sphenoid sinus. b MRI T2WI showing 33 x 16 mm hypo-isointense lesion in both on the left optic canal region and extending into the orbit. c MRI T1WI showing an isointense signal of the lesion. d Enhanced MRI showing ring enhancement of the lesion. e Photomicrograph of the surgical specimen revealing the histologic findings of the septate, clustered aspergillus hyphae. f MRI showing the resection of the mass
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Fig3
Bone destruction was seen in the left wall of the sphenoid sinus (Fig. 3a). T2-weighted signal were seen in paranasal sinuses (Fig. 3b-d). A biopsy was performed immediately, and histopathologic examination revealed an Aspergillus species (Fig. 3e). Post-operative images indicated the resection of mass (Fig. 3f).
PMC7398181_04
Case 4: a 50-year-old woman. a CT image showing an isodense lesion within the region of the left cavernous sinus left orbital apex, left optic nerve canal, and sphenoid sinus, with bone destruction in the left wall of the sphenoid sinus. b MRI showing a patchy lesion with the hyperintense signal on T2WI in the left cavernous sinus region. c MRI T1WI showing an isointense signal of the lesion. d Enhanced MRI showing noticeable enhancement of the lesion. e Photomicrograph of the surgical specimen revealing the histologic findings of septate, clustered aspergillus hyphae. f MRI showing the resection of the mass
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Fig4
The optic nerve could not be distinguished from the lesion (Fig. 4a). MRI showed a 21 x 26 mm patchy lesion that was isointense on T1WI and hyperintense on T2WI in the left cavernous sinus region (Fig. 4b, c). The lesion was closely related to the dura mater and extended to the sphenoid sinus and optic apex, partly surrounding the left internal carotid artery (Fig. 4d). A biopsy was performed immediately and histopathologic examination revealed Aspergillus species (Fig. 4e). Post-operative images indicated the resection of the mass (Fig. 4f).