Right parietal cryptococcoma in a young immunocompetent patient: illustrative case.

Area of Science:

• Neuroscience
• Infectious Diseases
• Pathology

Background:

• Cryptococcoma is a rare form of central nervous system (CNS) cryptococcosis.
• While typically seen in immunocompromised patients, cases in immunocompetent individuals are increasing.
• These cases are often misdiagnosed initially.

Purpose of the Study:

• To highlight the diagnostic challenges and management of cryptococcoma in an immunocompetent patient.
• To emphasize the importance of considering cryptococcoma in the differential diagnosis of brain lesions.

Main Methods:

• Case presentation of a 39-year-old immunocompetent male with neurological symptoms.
• Diagnostic imaging revealing a lesion suggestive of neoplasm.
• Surgical resection for histopathological confirmation and subsequent antifungal therapy.

Main Results:

• Histopathological analysis confirmed cryptococcoma.
• The patient showed symptom improvement after surgical resection and antifungal treatment.
• Imaging findings mimicked brain neoplasms, causing diagnostic uncertainty.

Conclusions:

• CNS cryptococcosis manifestations vary with immune status.
• In immunocompetent patients, cryptococcomas present as granulomatous reactions and can be insidious.
• Surgical resection is crucial for diagnosis and treatment, especially when imaging is equivocal and tests lack sensitivity.