Keywords
Fungal Infections
Oncology
Neurosurgery
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Abstract
Objective: To report a rare case of cerebellar cryptococcoma mimicking metastasis in an oncology patient, highlighting the importance of differential diagnosis and appropriate management of opportunistic fungal infections. Case details: A 22-year-old previously immunocompetent woman was diagnosed with cervical cancer and underwent chemotherapy and radiotherapy. During treatment, she developed neurological symptoms, including headache and tremor in the left upper limb. Cranial magnetic resonance imaging revealed an expansive cerebellar lesion with characteristics suggestive of metastasis, along with signs of obstructive hydrocephalus. Surgical intervention with lesion resection was performed. Histopathological examination confirmed the presence of Cryptococcus neoformans, establishing the diagnosis of cerebellar cryptococcoma. Despite her previously intact immune status, the patient developed immunosuppression secondary to oncological treatment, predisposing her to fungal infection. Additional procedures, such as cerebrospinal fluid leak repair and ventriculoperitoneal shunting, were performed for hydrocephalus management. Antifungal therapy was initiated, leading to a favorable clinical outcome. Final considerations: This case highlights the importance of differential diagnosis in cerebellar lesions in oncology patients, particularly in cases with a strong suspicion of metastasis. Early recognition and appropriate management are essential to prevent severe neurological complications and improve prognosis.
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