Neurocryptococcosis is a common mycotic central nervous system infection caused by the neurotropic fungus Cryptococcus neoformans 1 . It is most frequently found as the pathological presentation of cryptococcal meningoencephalitis 1 . Other rare forms of central nervous system cryptococcal infections are their solid-granulomatous appearance and abscesses, both being commonly named neurocryptococcomas, because of the mass effect they cause in surrounding tissue and their "tumoral aspect", many times simulating a brain tumor. Alternatively, Nucci et al. 2 described the unique report of a pseudocystic form of neurocryptococcosis. These medical conditions were classically described in immunocompromised hosts, mainly in HIV/AIDS infected patients.However, more recently, such disease has also been found in HIV-negative, immunocompetent individuals 1,3,4 . HIV-negative patients who were diagnosed with neurocryptococcoma had frequently other predisposing conditions to immunologic dysfunction such as sarcoidosis, diabetes, recent use of glucocorticoid or other immunossupresive therapy, as pointed by Gologorsky et al. 4 .
CASEA 46 year-old male patient was admitted to the emergency room complaining of about two months of occipital headache, associated with nausea and vomiting in the last two days. Altered mental status had already been detected by his family within the last twelve hours before admittance. On neurological examination there was mild confusion and Glasgow coma scale score was 13. The patient was submitted to a contrast enhanced head computed tomography (CT) scan, which revealed a left cerebellar hemispheric tumor-like lesion with ring-like contrast enhancement, measuring about 2.8 cm on its major diameter. The lesion presented with surrounding edema, which caused fourth [A, B and C]. Complete resection of the lesion by a suboccipital craniectomy is shown in Fig 1D.