Related Experiment Video
Updated: Jul 7, 2026

Role of Diffusion MRI Tractography in Endoscopic Endonasal Skull Base Surgery
Published on: July 5, 2021
Brain stem candidiasis mimicking cerebellopontine angle tumor
Xin-yu Hong1, Yu-Cheng Chou, Jorge A Lazareff
1Neurosurgery Department, First Hospital of Ji Lin University, Chang Chun, China.
Background:
Infectious process can mimic cerebral tumors. We present the first report of a fugal infection in brainstem mimicking cerebral tumors in the literature.
Case Description:
A 17-month-old boy presented with abnormal movements of his left arm and difficulty walking for 2 weeks. The MRI of the patient showed an enhancing partially cystic and partially solid mass in the right CP angle cistern, interpreting as CP tumor. On MRS, there was a decreased N-acetylaspartate/Creatine ratio and an elevated choline/Cr ratio. The patient underwent right retrosigmoid craniotomy and excisional biopsy. On the specimen, there were numerous fungal organisms consistent with Candida species. Our patient recovered completely after and 377-day voriconazole treatment. He was still quite well without neurologic sequelae at follow-up for 2 years.
Conclusions:
Brainstem candidiasis in immunocompetent host can masquerade the CP angle tumor. The MRI and MRS are not always diagnostic. Neurosurgical intervention is mandatory to relieve the mass effect in brainstem with high risk and achieve the pathologic diagnosis. Followed by voriconazole treatment, the patient could be treated successfully.
Related Concept Videos
Cryptococcal Meningitis
Increased Intracranial Pressure ll: Pathophysiology
Brain Abscess l: Introduction
Cerebral Edema ll: Pathophysiology
Brainstem
The Midbrain
The midbrain is located beneath the diencephalon and connects the cerebrum with the lower parts of the brain. The cerebral peduncles are prominent midbrain structures that house the...
Increased Intracranial Pressure l: Introduction

