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Oribital apex syndrome caused by aspergilloma in an immunocompromised patient with cutaneous lymphoma: A case report of a rare entity

Azad Cheko, Suzin Jung, Sarah Teuber-Hanselmann, Abidemi Wasiu Oseni, Anastasios Tsogkas, Martin Scholz, Athanasios K Petridis

Abstract


A 57-year-old man with a history of chemotherapy because of cutaneous lymphoma presented with an orbital apex syndrome. The cranial computed tomography scan revealed a tumour in the orbital apex, extending intradurally. With a suspected diagnosis of a neoplastic lesion, the patient underwent orbital surgery with optic nerve decompression. Histology revealed an aspergilloma. No other foci were seen and treatment with antifungals was started. In immunocompromised patients with intracranial tumours, infection is always a major consideration in the differential diagnosis, even if the reason for immunosuppression (in this case chemotherapy) dates back several months. Misdiagnosing an orbital apex lesion as a cancer and treating patients primarily with corticosteroids can be life threatening. Removal or biopsy of such lesions is essential in further treatment since antifungals have to be administered as fast as possible. 


Authors' affiliations

Azad Cheko, Department of Neurosurgery, Sana Hospitals Duisburg, Duisburg, Germany

Suzin Jung, Department of Neurosurgery, Sana Hospitals Duisburg, Duisburg, Germany

Sarah Teuber-Hanselmann, Institute of Neuropathology, University of Duisburg-Essen, Essen, Germany

Abidemi Wasiu Oseni, Neurosurgical Division, Department of Surgery, Lagos University Teaching Hospital, Lagos, Nigeria

Anastasios Tsogkas, Department of Neurosurgery, Sana Hospitals Duisburg, Duisburg, Germany

Martin Scholz, Department of Neurosurgery, Sana Hospitals Duisburg, Duisburg, Germany

Athanasios K Petridis, Department of Neurosurgery, Sana Hospitals Duisburg, Duisburg, Germany

Full Text

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Keywords

Orbital apex syndrome; Aspergilloma; Cutaneous lymphoma; Antifungal; Immunocompromise

Cite this article

South African Medical Journal 2016;106(4):354-355. DOI:10.7196/SAMJ.2016.v106i4.9936

Article History

Date submitted: 2015-08-16
Date published: 2016-03-17

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