Type:
Educational Exhibit
Keywords:
Neuroradiology brain, Soft tissues / Skin, Other, CT, MR, Treatment effects, Infection
Authors:
M.-T. Ciubuc-Batcu
DOI:
10.26044/ranzcr2023/C-169
Conclusion
The cryptococcomas caused by C. gattii infection are generally indistinguishable from tumours on CT imaging. Given the marked statistical prevalence of malignancy compared to C. gattii even in countries where infection is endemic, most patients are investigated down a cancer pathway with further CT and PET-CT scans that again cannot distinguish between the two. It is typically only after biopsy that MRI brain is performed and characteristic lesions are found. This exposes the patient to substantial radiation and procedural risk. Given the primary distinguishing features of malignancy and C. gattii infection lie in the history of neurological changes, the onus of initial diagnosis lies with the clinician. However, it is of note that ground glass appearance surrounding a pulmonary mass is not specific solely to malignancy, and raising the possibility of Cryptococcus infection when reporting such scans may prompt appropriate investigations sooner.