{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T15:43:27Z","timestamp":1787067807590,"version":"build-2736575974"},"reference-count":11,"publisher":"Scientific Scholar","content-domain":{"domain":["surgicalneurologyint.com"],"crossmark-restriction":true},"short-container-title":[],"abstract":"\n Background:<\/jats:title>\n Cryptococcal infections of the central nervous system are infrequent in immunocompetent hosts and usually present as meningitis. However, a fungal mass called a cryptococcoma may form, requiring caution in therapeutic intervention. Here, we report a rare case in which treatment of intraventricular cryptococcoma in an immunocompetent patient was facilitated by rapid pathological diagnosis.<\/jats:p>\n <\/jats:sec>\n \n Case Description:<\/jats:title>\n \n A 58-year-old previously healthy man was admitted to our hospital with fever, headache, and gradually worsening hearing loss over 1 month. Cerebrospinal fluid analysis showed moderately elevated levels of protein and lymphocytic cells and decreased glucose. In addition, \u03b22-microglobulin was highly elevated. Magnetic resonance imaging showed homogeneously enhanced lesions in lateral ventricles of the left and right hemispheres and the subarachnoid space, and\n 18<\/jats:sup>\n F-fluorodeoxyglucose positron emission tomography revealed abnormal uptake corresponding to the lesion. A surgical excision was performed to achieve a definitive diagnosis. Intraoperative rapid pathology, including immunohistochemistry (IHC), yielded negative results for malignant tumor, suggesting the possibility of inflammatory granuloma. Additional targeted pathological diagnosis was immediately performed. Paraffin-embedded histopathological examination showed fibrocaseous granuloma and numerous fungal spores.\n Cryptococcus neoformans<\/jats:italic>\n within the granuloma were suggested by Fontana\u2013Masson and Grocott staining and confirmed by polymerase chain reaction (PCR), leading to a diagnosis of cryptococcoma. Antifungal agents were started 3 days postoperatively. The patient has since been doing well, with no recurrence.\n <\/jats:p>\n <\/jats:sec>\n \n Conclusion:<\/jats:title>\n This pathology can be difficult to distinguish from a brain tumor, so early pathological diagnosis, including rapid pathology with IHC and PCR, may be crucial.<\/jats:p>\n <\/jats:sec>","DOI":"10.25259\/sni_614_2024","type":"journal-article","created":{"date-parts":[[2024,9,13]],"date-time":"2024-09-13T06:47:58Z","timestamp":1726210078000},"page":"330","update-policy":"https:\/\/doi.org\/10.25259\/crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["A case of immunocompetent intracranial cryptococcoma in which intraoperative rapid pathological diagnosis and polymerase chain reaction led to early treatment: What to know to avoid misdiagnosis as brain tumor"],"prefix":"10.25259","volume":"15","author":[{"given":"Saho","family":"Fujishita","sequence":"first","affiliation":[{"name":"Department of Neurology and Geriatric Medicine, Ehime University School of Medicine, Toon, Ehime, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Akihiro","family":"Inoue","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Ehime University School of Medicine, Toon, Ehime, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hideaki","family":"Watanabe","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Ehime University School of Medicine, Toon, Ehime, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Masahiro","family":"Nishikawa","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Ehime University School of Medicine, Toon, Ehime, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mashio","family":"Taniwaki","sequence":"additional","affiliation":[{"name":"Division of Diagnostic Pathology, Ehime University School of Medicine, Toon, Ehime, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sayaka","family":"Matsumoto","sequence":"additional","affiliation":[{"name":"Department of Neurology and Geriatric Medicine, Ehime University School of Medicine, Toon, Ehime, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Masayuki","family":"Ochi","sequence":"additional","affiliation":[{"name":"Department of Neurology and Geriatric Medicine, Ehime University School of Medicine, Toon, Ehime, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Koichiro","family":"Suemori","sequence":"additional","affiliation":[{"name":"Department of Hematology, Clinical Immunology and Infectious Diseases, Ehime University School of Medicine, Toon, Ehime, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Akira","family":"Watanabe","sequence":"additional","affiliation":[{"name":"Medical Mycology Research Center, Chiba University, Chiba, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Riko","family":"Kitazawa","sequence":"additional","affiliation":[{"name":"Division of Diagnostic Pathology, Ehime University School of Medicine, Toon, Ehime, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Seiji","family":"Shigekawa","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Ehime University School of Medicine, Toon, Ehime, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yasumasa","family":"Ohyagi","sequence":"additional","affiliation":[{"name":"Department of Neurology and Geriatric Medicine, Ehime University School of Medicine, Toon, Ehime, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Takeharu","family":"Kunieda","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Ehime University School of Medicine, Toon, Ehime, 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