Cerebellar Cryptococcoma in Immunocompetent Patients

A Case Report and Literature Review

Abstract

Cerebellar cryptococcoma is a rare clinical condition and is seldom considered as a differential diagnosis for cerebellar masses. Here, we present a case of cerebellar cryptococcoma mimicking abscess in an immunocompetent patient and summarize recent related studies in brief. The incidence of cerebellar cryptococcoma in immunocompetent patients has increased to up to 5 cases reported since 2007, but no case was reported before. A 68-year-old nonimmunocompromised woman complained of progressive occipital headache, vomiting, fatigue, and slight dizziness. Magnetic resonance imaging revealed an irregular lobulated thick-walled cystic lesion present within the cerebellum. The patient underwent a right suboccipital craniotomy for gross total resection of the lesion. The cryptococcoma was diagnosed subsequently by pathologic examination. A full course of antifungal treatment was administrated and the patient had full recovery with no lesion recurrence. Although it is a rare clinical condition in immunocompetent patients, cerebellar cryptococcoma needs to be taken into consideration in the differential diagnosis of cystic lesions of the cerebellum. Practically, microsurgical excision not only solves the mass-occupying effect, but also obtains histologic examination for confirmatory diagnosis. Microsurgical excision-combined antifungal treatment led to a good result in the present case.