• PaivaAline Lariessy CamposALCMD. Resident, Discipline of Neurosurgery, Faculdade de Ciências Médicas da Santa Casa de São Paulo (FCMSCSP), São Paulo (SP), Brazil., Guilherme Brasileiro de Aguiar, Renan Maximilian Lovato, Arthus Vilar Deolindo Zanetti, Alexandros Theodoros Panagopoulos, and VeigaJosé Carlos EstevesJCEPhD. Full Professor and Head, Discipline of Neurosurgery, Faculdade de Ciências Médicas da Santa Casa de São Paulo (FCMSCSP), São Paulo (SP), Brazil..
• MD. Resident, Discipline of Neurosurgery, Faculdade de Ciências Médicas da Santa Casa de São Paulo (FCMSCSP), São Paulo (SP), Brazil.
• Sao Paulo Med J. 2018 Sep 1; 136 (5): 492496492-496.

ContextCentral nervous system (CNS) infectious diseases have high prevalence in developing countries and their proper diagnosis and treatment are very important for public health planning. Cryptococcus neoformans is a fungus that may cause several CNS manifestations, especially in immunocompromised patients. Cryptococcal meningitis is the most common type of involvement. Mass-effect lesions are uncommon: they are described as cryptococcomas and their prevalence is even lower among immunocompetent patients. The aim here was to report an extremely rare case of cryptococcoma causing a mass effect and mimicking a brain tumor in an immunocompetent patient. The literature on CNS cryptococcal infections was reviewed with emphasis on cryptococcomas. Clinical, surgical and radiological data on a female patient with this rare presentation of cryptococcoma mimicking a brain tumor are described.Case ReportA 54-year-old female patient presented to the emergency department with a rapid-onset progressive history of confusion and completely dependency for basic activities. Neuroimaging showed a left occipital lesion and neurosurgical treatment was proposed. From histopathological evaluation, a diagnosis of cryptococcoma was established. She received clinical support with antifungals, but despite optimal clinical treatment, her condition evolved to death.ConclusionsCryptococcal infections have several forms of presentation and, in immunocompetent patients, their manifestation may be even more different. Cryptococcoma is an extremely rare presentation in which proper surgical and clinical treatment should be instituted as quickly as possible, but even so, there is a high mortality rate.

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