versão impressa ISSN 0004-282X
Arq. Neuro-Psiquiatr. vol.67 no.3b São Paulo set. 2009
Cerebellar cryptococcoma simulating metastatic neoplasm
Hélio A.G. Teive; Walter O. Arruda; Lineu César Wemeck
Neurology Service, Internal Medicine Department Hospital de Clínicas Federal University of Paraná E-mail: email@example.com.
We read with great interest the paper of Sillero-Filho et al., entitled "Cerebellar cryptococcoma simulating metastatic neoplasm", published recently in Arquivos de Neuropsiquiatria1. The authors described a 46 year-old male patient with left cerebellar hemispheric tumor-like lesion who had an initial diagnostic hypothesis of cerebellar metastatic lesion or even piogenic cerebellar abscess. After the surgical removal of the mass lesion, pathological examination revelead a cerebellar cryptococcoma. The authors emphasized that this was the first case of a solid cryptococcal mass lesion reported in Brazil1. In truth, Sion et al. presented in 1988, during the 13th Brazilian Congress of Neurology, a case report of a young female patient, with posterior fossa cryptococcomas, particularly in the cerebellum. The diagnosis was confirmed after necropsy examination2. On the other hand, there are several reports in the world literature of infectious granulomas, simulating posterior fossa tumor, besides cerebellar cryptococcoma, such as paracoccidioidomycosis granuloma3, cerebellar aspergiloma4, and cerebellar tuberculoma5. Then, the differential diagnosis of posterior fossa tumoral lesion should be expanded and include several other infectious granulomas, particularly fungic granulomas.
l. Sillero-Filho VJ, Martins de Souza AB, Vaitsman RP, et al. Cerebellar cryptococcoma simulating metastatic neoplasm. Arq Neuropsiquiatr 2009;67:290-292.
2. Sion J, Bleggi-Torres LF, Minguetti G, Teive HAG, Arruda WO, Telles FQ. Criptococose de fossa posterior: relato de caso. Arq Neuropsiquiatr 1988;46(Suppl):S210. [ Links ]
3. Teive HAG, Arruda WO, Ramina R, Meneses MS, Bleggi-Torres LF, Telles-Filho FQ. Paracoccidioidomycosis granuloma simulating posterior fossa tumour. J Royal Soc Med 1991;84:562-563. [ Links ]
4. Erdogan E, Beyzadeoglu M, Arpaci F, Celasun B. Cerebellar aspergillosis: case report and literature review. Neurosurgery 2002;50:874-876. [ Links ]
5. Alzal M, Qureshi SM, Ghaffar A, et al. Cerebellar tuberculosis mimicking posterior cranial fossa tumour. J Coll Physicians Surg Pak 2007;17:761-763. [ Links ]