Open AccessNeurocryptococcosis and leptomeningeal carcinomatosis in metastatic prostate adenocarcinoma: differential diagnoses or overlapping symptoms?
Author(s) -
Ana Cláudia Kutax Buiar,
Fernanda de Almeida Vieira,
Ricardo Pasquini Neto,
Mariana Cristina Gomes-Morila,
Gabriela Sulzbach-Solanho,
Daniela Sasso Pasquini,
João Victor Pruner-Vieira,
Maria Cristina Figueroa-Magalhães
Publication year - 2022
Publication title -
brazilian journal of case reports
Language(s) - English
Resource type - Journals
ISSN - 2763-583X
DOI - 10.52600/2763-583x.bjcr.2022.2.2.76-88
Subject(s) - medicine , meningeal carcinomatosis , headaches , differential diagnosis , cerebrospinal fluid , magnetic resonance imaging , radiology , carcinosis , pathology , cancer , surgery , peritoneal carcinomatosis , colorectal cancer
Acute headaches with red flags in patients with cancer may indicate metastasis or infection. This report describes a case of acute headache with red flags in a patient with metastatic prostate adenocarcinoma who presented a positive latex fixation test without pleocytosis in cerebrospinal fluid (CSF) analysis. Antifungal treatment was initiated based on the test's high accuracy combined with the patient’s clinical condition and radiological impression of infectious meningitis, although we could not exclude associated secondary neoplastic involvement. Clinical improvement was first observed on D4 of treatment. On D14, CSF examination revealed therapeutic efficacy but positive oncotic cytology. The patient subsequently had new episodes of headache with warning signs and magnetic resonance imaging showed leptomeningeal carcinomatosis. Although neurocryptococcosis and leptomeningeal carcinomatosis are rare neurological complications, they may coexist with overlapping symptoms.