Posterior fossa midline cryptococcoma in a patient with idiopathic CD4 lymphocytopenia

Rai, Sumit; Marak, Rungmei S. K.; Jain, Shruti; Tn, Dhole

doi:10.4103/0255-0857.99510

Cited by 10 publications

(12 citation statements)

References 6 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…4,[9][10][11][12][13][14][15][16][17][18][19] Surgical excision and debulking are indicated as adjunct therapies for lesions that are greater than or equal to 3 cm. 11,20 The type of neurological manifestation and the findings from neuroimaging depend on the patient's immunological status.…”

Section: Case Reportmentioning

confidence: 99%

Cryptococcoma mimicking a brain tumor in an immunocompetent patient: case report of an extremely rare presentation

et al. 2017

View full text Add to dashboard Cite

CONTEXT: Central nervous system (CNS) infectious diseases have high prevalence in developing countries and their proper diagnosis and treatment are very important for public health planning. Cryptococcus neoformans is a fungus that may cause several CNS manifestations, especially in immunocompromised patients. Cryptococcal meningitis is the most common type of involvement. Mass-effect lesions are uncommon: they are described as cryptococcomas and their prevalence is even lower among immunocompetent patients. The aim here was to report an extremely rare case of cryptococcoma causing a mass effect and mimicking a brain tumor in an immunocompetent patient. The literature on CNS cryptococcal infections was reviewed with emphasis on cryptococcomas. Clinical, surgical and radiological data on a female patient with this rare presentation of cryptococcoma mimicking a brain tumor are described. CASE REPORT: A 54-year-old female patient presented to the emergency department with a rapid-onset progressive history of confusion and completely dependency for basic activities. Neuroimaging showed a left occipital lesion and neurosurgical treatment was proposed. From histopathological evaluation, a diagnosis of cryptococcoma was established. She received clinical support with antifungals, but despite optimal clinical treatment, her condition evolved to death. CONCLUSIONS: Cryptococcal infections have several forms of presentation and, in immunocompetent patients, their manifestation may be even more different. Cryptococcoma is an extremely rare presentation in which proper surgical and clinical treatment should be instituted as quickly as possible, but even so, there is a high mortality rate.

show abstract

Section: Case Reportmentioning

confidence: 99%

Cryptococcoma mimicking a brain tumor in an immunocompetent patient: case report of an extremely rare presentation

et al. 2017

View full text Add to dashboard Cite

show abstract

“…Undifferentiated and differentiated MSCs do not elicit allo-reactive lymphocyte proliferative responses and modulate immune responses. So, MSCs can be transplantable between HLAincompatible individuals [39].…”

Section: Mesenchymal Stem Cells and Rheumatoid Arthritismentioning

confidence: 99%

Human Umbilical Cord Mesenchymal Stem Cell Therapy for Patients with Active Rheumatoid Arthritis: Safety and Efficacy

Wang

Cong

et al. 2013

Stem Cells and Development

210

181

View full text Add to dashboard Cite

This study was designed to assess the safety and efficacy of human umbilical cord mesenchymal stem cells (UC-MSCs) in the treatment of rheumatoid arthritis (RA). In this ongoing cohort, 172 patients with active RA who had inadequate responses to traditional medication were enrolled. Patients were divided into two groups for different treatment: disease-modifying anti-rheumatic drugs (DMARDs) plus medium without UC-MSCs, or DMARDs plus UC-MSCs group (4×10(7) cells per time) via intravenous injection. Adverse events and the clinical information were recorded. Tests for serological markers to assess safety and disease activity were conducted. Serum levels of inflammatory chemokines/cytokines were measured, and lymphocyte subsets in peripheral blood were analyzed. No serious adverse effects were observed during or after infusion. The serum levels of tumor necrosis factor-alpha and interleukin-6 decreased after the first UC-MSCs treatment (P<0.05). The percentage of CD4(+)CD25(+)Foxp3(+) regulatory T cells of peripheral blood was increased (P<0.05). The treatment induced a significant remission of disease according to the American College of Rheumatology improvement criteria, the 28-joint disease activity score, and the Health Assessment Questionnaire. The therapeutic effects maintained for 3-6 months without continuous administration, correlating with the increased percentage of regulatory T cells of peripheral blood. Repeated infusion after this period can enhance the therapeutic efficacy. In comparison, there were no such benefits observed in control group of DMARDS plus medium without UC-MSCs. Thus, our data indicate that treatment with DMARDs plus UC-MSCs may provide safe, significant, and persistent clinical benefits for patients with active RA.

show abstract

“…The clinical presentation of this case differs, due to the absence of cryptococomas, which are solid lesions, mainly located in basal ganglia or cerebral white matter, corresponding to abscesses or granulomas, which can be detected by NMR; 12 , neoplasms of the central nervous system 13 , brain abscesses 14 and even tuberculomas 15 with diagnostic histopathological examination after surgical management.…”

Section: Discussionmentioning

confidence: 95%

“…La presentación clínica de este caso difiere, por la ausencia de criptococomas, que son lesiones sólidas, localizados principalmente en ganglios basales o sustancia blanca cerebral, que corresponden a abscesos o granulomas, que pueden detectarse por RMN; en algunos casos se plantearon diagnósticos diferenciales como malformaciones vasculares 12 , neoplasias del sistema nervioso central 13 , abscesos cerebrales 14 e incluso tuberculomas 15 con diagnostico al examen histopatológico posterior al manejo quirúrgico.…”

Section: Discussionunclassified

Cerebelitis criptococócica en paciente VIH negativo

et al. 2017

View full text Add to dashboard Cite

Introduction: Cryptococcosis is an opportunistic fungal infection whose etiology is Cryptococcus neofromans / C. gattii, complex which affects immunocompromised patients mainly. Meningeal infection is one of the most common presentations, but cerebellar affection is rare. Case Description: Male patient with 65 old years, from an area of subtropical climate with chronic exposure to poultry, without pathological antecedents, who presented clinical picture consistent with headache, fever, seizures and altered mental status. Clinical findings and diagnostic methods: Initially without menigeal signs or intracranial hypertension and normal neurological examination. Later, the patient developed ataxia, dysdiadochokinesia and limb loss. By lumbar punction and image of nuclear magnetic resonance (NMR) cerebellitis cryptococcal was diagnosticated. Treatment: Antifungal therapy with amphotericin B and fluconazole was performed, however the patient died. Clinical Relevance: The cryptococcosis has different presentations, it´s a disease whose incidence has been increasing since the advent of the HIV / AIDS pandemy, however the commitment of the encephalic parenchyma and in particular the cerebellum is considered rare. In this way we are facing the first case of cryptococcal cerebellitis in our midst.

show abstract

Posterior fossa midline cryptococcoma in a patient with idiopathic CD4 lymphocytopenia

Cited by 10 publications

References 6 publications

Cryptococcoma mimicking a brain tumor in an immunocompetent patient: case report of an extremely rare presentation

Cryptococcoma mimicking a brain tumor in an immunocompetent patient: case report of an extremely rare presentation

Human Umbilical Cord Mesenchymal Stem Cell Therapy for Patients with Active Rheumatoid Arthritis: Safety and Efficacy

Cerebelitis criptococócica en paciente VIH negativo

Contact Info

Product

Resources

About