A case of invasive paranasal aspergillosis that developed from a non-invasive form during 5-year follow-up

Invasive paranasal aspergillosis has been previously reported, but there have been no case reports of non-invasive paranasal aspergillosis that progressed to the invasive form during follow-up. A case of non-invasive aspergillosis of the maxillary sinus that appeared to become invasive during 5-year follow-up is reported. The patient was diagnosed as having non-invasive aspergillosis at the first visit because CT images revealed only mucosal thickening and calcifications in the right maxillary sinus. Five years later, CT images showed an invasive mass lesion in the orbit and large bone destruction of the posterior wall of the maxillary sinus. The patient was rescued by total removal of the orbital contents with zygomatic ostectomy followed by appropriate antifungal chemotherapy irrespective of residual tissue invasion. We would propose that appropriate surgical treatment and antifungal agents are necessary to improve the prognosis of invasive aspergillosis.