Cerebellar cryptococcoma simulating metastatic neoplasm

Sillero-Filho, Valter José; Souza, Arthur Borges Martins de; Vaitsman, Rafael Pereira; Morais, Rodrigo Ayres de; Coutinho, Pedro de Oliveira; Lengruber, Renata; Salame, José Massoud; Guedes-Corrêa, José Fernando; Louzada, Paulo Roberto

doi:10.1590/s0004-282x2009000200022

Cited by 9 publications

(5 citation statements)

References 7 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Most were in immunocompetent patients, chronic and progressive headache associated with nausea and vomiting was the main symptom during the onset of the disease. One case had cerebellar symptoms such as ataxia and dysdiadochokinesia 9 ; in another case the alteration of the state of consciousness was one of the first symptoms 10 , and in another no meningeal signs were reported 11 .…”

Section: Discussionmentioning

confidence: 99%

“…La mayoría se presentaron en pacientes inmunocompetentes, la cefalea crónica y progresiva asociada a nausea y vómito, fue el principal síntoma durante el debut de la enfermedad. Un caso presentó síntomas cerebelosos como ataxia y disdiadococinesia 9 ; en otro caso la alteración del estado de conciencia fue uno de los primeros síntomas 10 y en otro tampoco se reportaron signos meníngeos 11 .…”

Section: Discussionunclassified

See 1 more Smart Citation

Cerebelitis criptococócica en paciente VIH negativo

et al. 2017

View full text Add to dashboard Cite

Introduction: Cryptococcosis is an opportunistic fungal infection whose etiology is Cryptococcus neofromans / C. gattii, complex which affects immunocompromised patients mainly. Meningeal infection is one of the most common presentations, but cerebellar affection is rare. Case Description: Male patient with 65 old years, from an area of subtropical climate with chronic exposure to poultry, without pathological antecedents, who presented clinical picture consistent with headache, fever, seizures and altered mental status. Clinical findings and diagnostic methods: Initially without menigeal signs or intracranial hypertension and normal neurological examination. Later, the patient developed ataxia, dysdiadochokinesia and limb loss. By lumbar punction and image of nuclear magnetic resonance (NMR) cerebellitis cryptococcal was diagnosticated. Treatment: Antifungal therapy with amphotericin B and fluconazole was performed, however the patient died. Clinical Relevance: The cryptococcosis has different presentations, it´s a disease whose incidence has been increasing since the advent of the HIV / AIDS pandemy, however the commitment of the encephalic parenchyma and in particular the cerebellum is considered rare. In this way we are facing the first case of cryptococcal cerebellitis in our midst.

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Discussionunclassified

Cerebelitis criptococócica en paciente VIH negativo

et al. 2017

View full text Add to dashboard Cite

show abstract

“…A review of the literature revealed only 5 reported cases. 3,4,6,12,13 Data regarding these cases are summarized in Table 1. Only 1 case reported by Kanaly et al 4 had a pulmonary lesion that was caused by sarcoidosis.…”

Section: Discussionmentioning

confidence: 99%

Cerebellar Cryptococcoma in Immunocompetent Patients

Jiang

Xiang

Yong

et al. 2012

Neurosurgery Quarterly

View full text Add to dashboard Cite

Cerebellar cryptococcoma is a rare clinical condition and is seldom considered as a differential diagnosis for cerebellar masses. Here, we present a case of cerebellar cryptococcoma mimicking abscess in an immunocompetent patient and summarize recent related studies in brief. The incidence of cerebellar cryptococcoma in immunocompetent patients has increased to up to 5 cases reported since 2007, but no case was reported before. A 68-year-old nonimmunocompromised woman complained of progressive occipital headache, vomiting, fatigue, and slight dizziness. Magnetic resonance imaging revealed an irregular lobulated thick-walled cystic lesion present within the cerebellum. The patient underwent a right suboccipital craniotomy for gross total resection of the lesion. The cryptococcoma was diagnosed subsequently by pathologic examination. A full course of antifungal treatment was administrated and the patient had full recovery with no lesion recurrence. Although it is a rare clinical condition in immunocompetent patients, cerebellar cryptococcoma needs to be taken into consideration in the differential diagnosis of cystic lesions of the cerebellum. Practically, microsurgical excision not only solves the mass-occupying effect, but also obtains histologic examination for confirmatory diagnosis. Microsurgical excision-combined antifungal treatment led to a good result in the present case.Key Word: antifungal treatment, cystic brain tumor, cerebellum, cryptococcoma, microsurgical excision, tuberculous abscess (Neurosurg Q 2012;22:266-270) C ryptococcosis is thought to be the most prevalent fungal infection involving the central nervous system (CNS). 1,2 The most frequent manifestations of CNS cryptococcal infections are cryptococcal meningitis or meningoencephalitis. 1,3,4 It is much more common for cryptococcal infections of the CNS to occur in patients with human immunodeficiency virus (HIV) infection and other immunosuppressed conditions. 4,5 Rarely, solitary cerebral lesions attributed to cryptococcosis are considered in the differential diagnosis of abscess or cystic tumors, and they are much more uncommon to be localized in the cerebellum in immunocompetent patients. 3,6 We present a case of a solitary cerebellar cryptococcoma mimicking an abscess or a cystic neoplasm, treated successfully by microsurgery together with antifungal therapy, suggesting the importance of early recognition of this disease in immunocompetent patients. CASE REPORTOur patient is a 68-year-old woman who presented with progressive occipital headache, vomiting, fatigue, and slight dizziness for 2 weeks. Her medical history showed that she was healthy and did not have any long-term medication or drug abuse. Before being treated by our hospital, she took some antibiotics to prevent bacterial infection, as she was diagnosed with a common cold at a local hospital. On the day of admission, her general physical examination and vital signs including body temperature were normal. On neurological examination, she was conscious, oriented, and her speec...

show abstract

“…2 CNS cryptococcoma is a rare condition affecting the cerebral hemispheres or cerebellum. 3,4 It is secondary to infectious spread along the perivascular spaces (Virchow-Robins [VR] spaces) into the brain parenchyma. This fungus typically colonises the VR spaces.…”

Section: Discussionmentioning

confidence: 99%