PMID- 25298916
OWN - NLM
STAT- PubMed-not-MEDLINE
DCOM- 20141009
LR  - 20211021
IS  - 2229-5097 (Print)
IS  - 2152-7806 (Electronic)
IS  - 2152-7806 (Linking)
VI  - 5
DP  - 2014
TI  - Paracoccidioidomycosis simulating brain tumor.
PG  - 134
LID - 10.4103/2152-7806.140656 [doi]
LID - 134
AB  - BACKGROUND: Paracoccidioidomycosis (PCM) is a systemic granulomatous disease 
      caused by Paracoccidioides brasiliensis. Involvement of the central nervous 
      system (CNS) occurs in about 10% of cases. CASE DESCRIPTION: A 57-year-old white 
      man presented with the complaint of headache and an episode of focal seizure 1 
      month earlier. Magnetic resonance imaging (MRI) revealed a ring-enhancing lesion 
      in the right parietal lobe with peri-lesional vasogenic edema suggestive of a 
      primary neoplasm. The patient underwent craniotomy and the intraoperative finding 
      was a yellowish, hard lesion with thick content and yellow inside. 
      Anatomo-pathological findings were pathognomonic of PCM: large, thick-walled, 
      spherical yeast cells with multiple peripheral buds. The patient tested negative 
      for human immunodeficiency virus (HIV). Encephalitis and meningitis were ruled 
      out by cerebrospinal fluid analysis. Culture confirmed the diagnosis of PCM and 
      the patient was treated with amphotericin B. The patient responded well to 
      treatment with resolution of the headache and clinical improvement, despite a 
      bitemporal hemianopia. He was clinically stable and then discharged in good 
      general condition. CONCLUSIONS: Radiographic findings of PCM with CNS involvement 
      may suggest neoplasia, making diagnosis difficult. In endemic areas, the 
      diagnosis of PCM should be promptly considered when a ring-enhancing mass 
      associated with peri-lesional edema is observed on MRI.
FAU - Isolan, Gustavo R
AU  - Isolan GR
AD  - Department of Neurology, Hospital de Clinicas de Porto Alegre, Rua Ramiro 
      Barcelos 2350, 90035-903, Porto Alegre, RS, Brazil ; Graduate Program in 
      Medicine: Surgical Sciences, School of Medicine, Universidade Federal do Rio 
      Grande do Sul, Rua Ramiro Barcelos 2400, 90035-003, Porto Alegre, RS, Brazil.
FAU - Vieira, Daniel M
AU  - Vieira DM
AD  - Department of Neurology, Hospital de Clinicas de Porto Alegre, Rua Ramiro 
      Barcelos 2350, 90035-903, Porto Alegre, RS, Brazil.
FAU - Hehn, Francine
AU  - Hehn F
AD  - Department of Pathology, Hospital de Clinicas de Porto Alegre, Rua Ramiro 
      Barcelos 2350, 90035-903, Porto Alegre, RS, Brazil.
FAU - Antunes, Apio C M
AU  - Antunes AC
AD  - Department of Neurology, Hospital de Clinicas de Porto Alegre, Rua Ramiro 
      Barcelos 2350, 90035-903, Porto Alegre, RS, Brazil ; Graduate Program in 
      Medicine: Surgical Sciences, School of Medicine, Universidade Federal do Rio 
      Grande do Sul, Rua Ramiro Barcelos 2400, 90035-003, Porto Alegre, RS, Brazil.
LA  - eng
PT  - Case Reports
DEP - 20140912
PL  - United States
TA  - Surg Neurol Int
JT  - Surgical neurology international
JID - 101535836
PMC - PMC4174673
OTO - NOTNLM
OT  - Brain neoplasms
OT  - central nervous system
OT  - magnetic resonance imaging
OT  - paracoccidioidomycosis
EDAT- 2014/10/10 06:00
MHDA- 2014/10/10 06:01
PMCR- 2014/09/12
CRDT- 2014/10/10 06:00
PHST- 2014/03/18 00:00 [received]
PHST- 2014/08/03 00:00 [accepted]
PHST- 2014/10/10 06:00 [entrez]
PHST- 2014/10/10 06:00 [pubmed]
PHST- 2014/10/10 06:01 [medline]
PHST- 2014/09/12 00:00 [pmc-release]
AID - SNI-5-134 [pii]
AID - 10.4103/2152-7806.140656 [doi]
PST - epublish
SO  - Surg Neurol Int. 2014 Sep 12;5:134. doi: 10.4103/2152-7806.140656. eCollection 
      2014.