Intraosseous maxillary phaeohyphomycosis mimicking an odontogenic cyst in an immunocompetent patient: a case report
Intraosseous maxillary phaeohyphomycosis mimicking an odontogenic cyst in an immunocompetent patient: a case report
DOI:
https://doi.org/10.51473/rcmos.v1i1.2026.2127Keywords:
Phaeohyphomycosis. Melanized fungi. Maxilla. Intraosseous lesion. Oral fungal infections.Abstract
Phaeohyphomycosis is a rare fungal infection caused by melanized fungi and may mimic odontogenic lesions when affecting the maxillofacial bones. Intraosseous involvement of the maxilla is exceptional, particularly in immunocompetent patients. A 50-year-old immunocompetent man presented with pain in the maxillary incisors and progressive buccal and palatal swelling. Computed tomography revealed an extensive hypodense intraosseous lesion involving teeth 22 to 12, with cortical bone destruction and extension into the nasal cavity, initially suggestive of an aggressive odontogenic cyst. Histopathological examination showed granulomatous inflammation with granular histiocytes, multinucleated giant cells, and cholesterol crystals. Grocott, PAS/PAS-D and Fontana-Masson stains demonstrated pigmented septate hyphae and spherical fungal structures consistent with dematiaceous fungi, confirming intraosseous phaeohyphomycosis. Surgical debridement associated with systemic itraconazole therapy resulted in complete resolution, with no recurrence after two years of follow-up. This case highlights the importance of including phaeohyphomycosis in the differential diagnosis of atypical intraosseous maxillary lesions and reinforces the decisive role of histopathological examination with special stains.
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Copyright (c) 2026 CLAUDIO PEREIRA, Patricia Freire Gasparetto, Leonardo Araújo de Andrade, Tessa de Lucena Botelho (Autor)
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