International Journal For Multidisciplinary Research

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Invasive Aspergillosis Mimicking Pituitary Adenoma in an Immunocompetent Patient: A Management Dilemma

Author(s) Dr. SAGNIK ROY, Prof. Dr. ANITA JAGETIA
Country India
Abstract Background: Sellar-suprasellar lesions are commonly pituitary adenomas ( PitNET(Pituitary neuroendocrine tumor) as per new WHO(World Health Organization) 5TH EDITION classification). However, rare infectious causes such as invasive aspergillosis (IA) may present with similar features, particularly in chronic fungal sinusitis cases, often leading to diagnostic challenges.
Case Summary: We report the case of a 35-year-old immunocompetent male who presented with a two-month history of holocranial headache, visual dimness, and right-sided ptosis. Examination revealed partial left third cranial nerve palsy. Hormonal evaluation indicated hyperprolactinemia. CEMRI(contrast enhanced magnetic resonance imaging) of the brain demonstrated a 19×39×21 mm sellar-suprasellar mass with parasellar invasion and bony erosion with diffuse enhancing mucosal thickening in paranasal sinuses. Positive serum Aspergillus antigen and elevated 1,3-β-D-glucan levels suggested fungal etiology. Antifungal therapy with intravenous voriconazole followed by oral medication for six weeks resulted in significant symptomatic and radiological improvement. Follow-up imaging revealed a reduced lesion size (4.5×11×10 mm), with full symptom resolution.
Conclusion: IA can rarely present as a sellar mass in immunocompetent individuals, mimicking pituitary neoplasms. This case underscores the importance of including fungal infections in the differential diagnosis of atypical pituitary region masses. Early diagnosis through imaging and fungal biomarkers enables effective antifungal management, potentially avoiding unnecessary surgical intervention.
Keywords SELLA, ASPERGILLOSES, FUNGAL, PITUITARY, BIOMARKERS, CRANIAL NERVE
Published In Volume 8, Issue 2, March-April 2026
Published On 2026-03-16
DOI https://doi.org/10.36948/ijfmr.2026.v08i02.71654
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