Cerebral phaeohyphomycosis masquerading as a parafalcian mass: case report

Surg Neurol. 2003 Oct;60(4):354-9; discussion 359. doi: 10.1016/s0090-3019(03)00135-6.

Abstract

Background: Cerebral phaeohyphomycosis caused by Fonsecaea pedrosoi is a rarity. However, about four cases have been reported in the literature. The disease remains mostly fatal despite employment of new treatment modalities.

Case: An 18-year-old boy presented seizures of recent onset. Two years back, he developed cutaneous phaeohyphomycosis after a splinter scratch on his chest wall. Imaging revealed a contrast enhancing parafalcian solid mass. Right frontal parasagittal craniotomy was performed and the lesion resected as much as possible, followed by IV amphotericin B and oral itraconazole treatment. The patient has been doing well during a 15-month follow-up period.

Discussion: Cerebral phaeohyphomycosis is an extremely rare lesion, which could masquerade as a parafalcian mass. Radical surgical removal together with antimicrobials remains the cornerstone treatment of cerebral phaeohyphomycosis.

Publication types

  • Case Reports

MeSH terms

  • Adolescent
  • Antifungal Agents / therapeutic use
  • Brain Neoplasms / diagnosis
  • Central Nervous System Fungal Infections / diagnosis*
  • Central Nervous System Fungal Infections / drug therapy
  • Central Nervous System Fungal Infections / microbiology*
  • Diagnosis, Differential
  • Humans
  • Itraconazole / therapeutic use
  • Magnetic Resonance Imaging
  • Male
  • Mitosporic Fungi* / isolation & purification
  • Seizures / microbiology*
  • Tomography, X-Ray Computed

Substances

  • Antifungal Agents
  • Itraconazole