Rhino-orbital-cerebral mucormycosis with skull base involvement mimicking an intracranial tumor in an immunocompetent patient

Mucormycosis is an aggressive invasive fungal infection that predominantly affects immunocompromised individuals and may be rapidly fatal if diagnosis and treatment are delayed. We report a man in his sixties with no known immunosuppressive conditions who presented with progressive headache, cranial nerve dysfunction, and sinusitis symptoms. Neuroimaging demonstrated an infiltrative skull base lesion with orbital and intracranial extension, initially suggestive of a neoplastic process. Surgical exploration and histopathological examination revealed invasive rhino-orbital-cerebral mucormycosis with extensive angioinvasion and tissue necrosis. The patient underwent surgical debridement followed by systemic antifungal therapy with amphotericin B, resulting in clinical stabilization and partial neurological recovery. This case highlights the importance of considering invasive fungal infection in the differential diagnosis of skull base masses, even in immunocompetent patients, and underscores the critical role of early biopsy and combined surgical and medical management.