MR imaging of intracranial aspergilloma extending from the sphenoid sinus in an immunocompromised patient with multiple myeloma.

A case of fatal intracranial aspergillosis, extending from the sphenoid sinus via the orbit into the subarachnoid space of the optochiasmatic cistern and the cistern of the middle cerebral artery is presented in an immunosuppressed patient with multiple myeloma. Adequate treatment was not instituted and the patient died because the condition was not recognised and interpreted as a soft tissue extension of an orbital localization of myeloma. MRI, especially after intravenous injection of Gadolinium, depicted very accurately the extension of the disease, as defined at autopsy.