Cerebellar cryptococcoma simulating metastatic neoplasm

OPINION/OPINIÃO

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: [e-mail].

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 13^th 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.

REFERENCES

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.
• 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.
• 4. Erdogan E, Beyzadeoglu M, Arpaci F, Celasun B. Cerebellar aspergillosis: case report and literature review. Neurosurgery 2002;50:874-876.
• 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.

Publication Dates

• Publication in this collection
  13 Oct 2009
• Date of issue
  Sept 2009