This 68 year man with a history of hypertension and ischemic heart disease presented with nasal obstruction, localised swelling and pain in his right cheek for about two months. CT scan showed a soft tissue mass filling the right maxillary sinus adjacent to the floor of the orbit. Maxillotomy with mass removal was performed and culture grew A. fumigatus. Histology was not performed and the patient received no antifungal therapy. 5 months later localised relapse with progression along the medial wall of the orbit was seen on CT scan.
Images provided by Dr Daša Cerar1, Dr Tatjana Lejko-Zupanc1, Dr Katarina Šurlan-Popovič2, and Dr Zmago Novak3 1 University Medical Centre Ljubljana, Department of Infectious Diseases, Japljeva 2, Ljubljana, Slovenia 2 University Medical Centre Ljubljana, Department of Radiology 3 University Medical Centre Maribor, Department of Infectious Diseases, Maribo