International Journal of Drug Delivery Technology
Volume 16, Issue 5s

Invasive Fungal Sinusitis Mimicking Pituitary Macroadenoma: A Case Report

Dr. P. Allice Frinitta1, Dr. Ashwin Kumar A2, Dr. G. Murugan3

1Postgraduate, Department of Radiodiagnosis, Sree Balaji Medical College and Hospital, Chennai, India
2Associate Professor, Department of Radiodiagnosis, Sree Balaji Medical College and Hospital, Chennai, India
3HOD and Professor, Department of Radiodiagnosis, Sree Balaji Medical College and Hospital, Chennai, India

ABSTRACT

Invasive fungal sinusitis is a rare but life-threatening condition that typically affects immunocompromised individuals. Its presentation can occasionally mimic other pathologies, leading to diagnostic challenges. We report an unusual case of invasive fungal sinusitis in an 82-year-old female who presented with headache, blurring of vision, diplopia, and generalized tremors. Laboratory investigations revealed elevated inflammatory markers including procalcitonin, leukocytosis, and raised C-reactive protein. Neuroimaging demonstrated a well-defined sellar and suprasellar lesion measuring approximately 2.8 × 2.3 × 2.8 cm with expansion of the sella turcica and inferior extension into the sphenoid sinus. A focal hyperdense area within the lesion raised suspicion for fungal concretions, hemorrhagic component, or proteinaceous material. The differential diagnosis included invasive fungal sinusitis and pituitary macroadenoma. Endoscopic transnasal sphenoidectomy revealed the sphenoid sinus cavity completely filled with thick, inspissated, grayish-brown to black necrotic material with friable fungal debris. Histopathological examination confirmed fungal infection. Complete debridement was performed, and the patient showed significant postoperative improvement. This case highlights the importance of considering invasive fungal sinusitis in the differential diagnosis of sellar masses, particularly in elderly patients with elevated inflammatory markers, and demonstrates the crucial role of surgical intervention in both diagnosis and management.

Keywords: Invasive fungal sinusitis, pituitary macroadenoma, sellar mass, sphenoid sinus, endoscopic sphenoidectomy

How to cite this article: Frinitta PA, Kumar A, Murugan G, Invasive Fungal Sinusitis Mimicking Pituitary Macroadenoma: A Case Report. Int J Drug Deliv Technol. 2026;16(5s): 265-269; DOI: 10.25258/ijddt.16.5s.33

Source of support: Nil

Conflict of interest: None