[Cryptococcoma in the central nervous system of a non-immunocompromised patient]

Central nervous system cryptococcosis is an important cause of morbidity and mortality in immunocompromised patients; nevertheless, its presentation in immuno-spared patients is extremely rare, giving rise to a hole different spectrum, since it is manifested like granulomatous masses named cryptococomas. AIM. To describe an intracerebral case of cryptococcoma in an immuno-spared woman in the Hospital Universitario de Santander and to discuss the most relevant topics of this pathology.

A 24 years-old woman, coming to the service presenting generalized tonic-clonic seizure, fixed upward gaze, sialorrhea and lost, without any data suggesting immunosupression. The computarized tomography of skull demonstrates a mass of possible inflammatory vs. noeplasmic origin. After performing imaging the patient is taken to surgery for craniotomy with excisional biopsy. By means of hystological analysis the diagnosis of cerebral criptococcoma is made, and antimycotic therapy is started, with favorable response. Actually the patient evidences good health, and no evidence of active disease.

The presence of masses of criptococcal origin located at the central nervous system, which origin is due to a chronic granulomatous reaction, is rarely reported; these appear in almost all cases in immunocompetent patients, in which there is of primary importance to discard all causes of cellular immune deficit. Also, the diagnosis of these injuries must be considered before the presence of intracerebral masses that show inflammatory characteristics.