Mucoceles are pathological lesions resulting from mucus accumulation in obstructed spaces, categorized as primary or secondary. Sphenoid sinus mucoceles with fungal balls are rarely reported but are treated with endoscopic sinus surgery and confirmed through pathological examination. In this case, a 60-year-old female presented with severe right-sided headaches and facial pressure. Imaging revealed an expansive mass in the right sphenoid sinus, suspected to be a mucocele with a potential fungal ball. Endoscopic surgery successfully removed the lesion without damaging critical structures, and aspergillosis was confirmed as the cause. Postoperative follow-up showed symptom resolution and no complications. This case report emphasizes the scarcity of sphenoid sinus mucoceles associated with fungal balls. Endoscopic sinus surgery remains a successful treatment option, ensuring symptom resolution and preventing complications. Regular postoperative follow-up is crucial for optimal outcomes.
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