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Intracranial fungal infection is uncommon condition with high morbidity and mortality. Recently, the incidence has increased owing to the increase of the number of immunocompromised patients (e.g., acquired immunodeficiency syndrome, uncontrolled diabetes mellitus, immunosuppressive drugs, and organ transplant). Furthermore, intracranial fungal granuloma is very uncommon in immunocompetent patients. Unfortunately, it may be masked as it may mimics meningioma clinically and radiologically which may further delay the diagnosis and treatment especially in absence of the risk factors of immunosuppression. Case Report: We will present a case of intracranial fungal granuloma that mimics olfactory grove meningioma both clinically and radiologically in absence of risk factors of immunosuppression with no paranasal sinuses involvement. In addition to that we will discuss the suspicious radiological signs that might help in making fungal granuloma more possible than meningioma. Conclusion: Preoperative diagnosis of intracranial fungal granuloma is challenging in immunocompetent patients, in the absence of evidence of nasal infection. There are some radiological clues that could help us to differentiate between fungal granuloma and meningioma preoperatively.

Fungal granuloma in immunocompetent patient masquerading as olfactory groove meningioma