Giant sphenoid sinus fungal ball causing secondary hypopituitarism and infertility: a case report

Isolated sphenoid sinus fungal balls are a rare but clinically significant entity, often presenting with nonspecific symptoms. This case highlights the importance of multidisciplinary collaboration among different specialties to achieve optimal patient outcomes. We report a case of a 29-year-old female presenting with recurrent pregnancy loss, referred by obstetrics for neurosurgical evaluation. Imaging revealed a giant sphenoid sinus fungal ball causing secondary hypopituitarism and infertility, a very rare complication. Subsequently, she was referred to ENT specialists, who did more imaging tests and removed the mass, leading to the restoration of pituitary function and pregnancy. This case highlights the importance of considering sphenoid sinus pathology in patients with unexplained endocrine dysfunctions and the critical role of multidisciplinary collaboration in diagnosis and management. It also underscores the necessity of imaging the sphenoid sinus in patients with unexplained hyperprolactinemia and infertility, even in the absence of classic sinonasal symptoms. Early recognition and surgical intervention can lead to the resolution of symptoms and restoration of normal physiological function, as demonstrated by the successful outcome in this patient.