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Case Reports in Otolaryngology
Volume 2012, Article ID 103403, 3 pages
http://dx.doi.org/10.1155/2012/103403
Case Report

Wegener's Granulomatosis with Extensive Bone Abnormalities Mimicking Fungal Sinusitis

Department of Otolaryngology, Oita University Faculty of Medicine, 1-1 Idaigaoka, Hazama-Machi, Oita, Yufu 879-5593, Japan

Received 21 March 2012; Accepted 22 May 2012

Academic Editors: M. T. Kalcioglu, H. Sudhoff, H.-W. Wang, and G. Zhou

Copyright © 2012 Satoru Kodama et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Abnormalities of the underlying bone of the paranasal sinuses have sometimes been shown in Wegener’s granulomatosis (WG). We describe an interesting case of WG with extensive bone abnormalities in the sinuses mimicking fungal sinusitis. A 30-year-old woman presented with intermittent unilateral epistaxis. Biopsy was performed for the granulation tissue in the right nasal cavity, and she was diagnosed as having WG. Computed tomography (CT) revealed a ring-like calcification, mimicking a fungus ball, in the right maxillary sinus. Endoscopic sinus surgery was performed to confirm the diagnosis. A spherical bony structure, surrounded by granulation tissue, was identified in the maxillary sinus. The wall of the “bony ball” was fragile, like an egg shell. No fungus was found in the sinus. Thus, the extensive bone abnormalities were due to WG.