Manipal Journal of Medical Sciences


Fungal granuloma of the sino-orbital region is uncommon. Although imaging modalities like CECT and MRI scans are usually helpful, a pre-operative diagnosis may still be difficult because of subtle overlapping clinical features and a rather indolent disease course. Due to the anatomical relations of the orbit, FNAC is generally difficult and has a high incidence of complications and false-negative results. We report a case of a middle-aged woman, who presented with a painless, progressive swelling below her right eyebrow with difficulty in looking upwards and to the right. Initial diagnoses of orbital dermoid cyst and frontal sinus mucocoele were made clinically. The origin of this lesion was unclear, was it a primary orbital pathology with secondary involvement of the frontal sinus, or vice versa? CECT and USG-guided FNAC aided in investigating, however, a definitive diagnosis of fungal granuloma was only established post-operatively, with the help of histopathological examination