Demographics:
75 years old, Male
Indication:
Neutropenic fever
Findings
- Circumferential mucosal thickening of the right maxillary sinus with bony dehiscence in the anterior and posterior walls and orbital floor
- Soft tissue extension superiorly into the right orbital floor contacting the inferior rectus muscle as well as posteriorly into the retroantral fat and pterygopalatine fossa
- Mild ethmoid, right sphenoid, and right frontal sinus mucosal thickening
Diagnosis
Invasive fungal sinusitis
Sample Report
Circumferential mucosal thickening of the right maxillary sinus with multifocal bony destruction and soft tissue extension superiorly into the right orbit contacting the inferior rectus muscle and posteriorly into the retroantral fat and pterygopalatine fossa. Findings are concerning for invasive fungal sinusitis in this neutropenic patient. Contrast enhanced face/sinuses MRI could further evaluate extent of disease, including evaluation for early intracranial extension.
Discussion