Clival Aspergillosis Excision by Endoscopic Transnasal Surgery: Rare Case Report

Clival aspergillosis is a rare, localized fungal infection caused by Aspergillus species, typically affecting the clivus, a bony structure at the base of the skull. It can be asymptomatic or present with nonspecific symptoms including headache, facial pain, nasal congestion, or cranial nerve deficits, depending on the extent of the lesion and adjacent structures involved. This report presented case of a 57 years old man with headache 20 days ago, had a medical history of 3 years ago with headache on the right side, without other neurological symptoms and performed a CT scan and MRI of brain and diagnosed as mass in clivus. Treatment strategies included surgical excision of clival aspergillosis by endoscopic transnasal, antifungal therapy, and treatment of any underlying conditions that may have led to fungal colonization. It was concluded that endoscopic endonasal transclival approach provides safe removal and good prognosis.