[Cryptococcoma of the adrenal gland]

The case is described of a 49-year-old man who developed cryptococcal meningo-encephalitis ten months before his death. Six months later complicating hydrocephalus occurred which required the implantation of a ventriculo-peritoneal shunt. A further four months later the patient, who was receiving anticoagulation therapy due to deep vein thrombosis, died from intraventricular cerebral haemorrhage. In a blood culture taken shortly before his death, growth of Cryptococcus neoformans was detected. At autopsy, which confirmed cerebral haemorrhage as the cause of death, a large cryptococcoma of the left adrenal gland was discovered as an incidental finding. We presume that this cryptococcoma was the source of the new haematogenous dissemination of the disease. We review the literature and discuss the increasing importance of cryptococcosis.