Cerebral phaeohyphomycosis masquerading as a parafalcian mass: case report.
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.


METHODS
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.


CONCLUSIONS
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.
D000293:Adolescent; D000935:Antifungal Agents / Q000627:therapeutic use; D001932:Brain Neoplasms / Q000175:diagnosis; D020314:Central Nervous System Fungal Infections / Q000175:diagnosis* / Q000188:drug therapy / Q000382:microbiology*; D003937:Diagnosis, Differential; D006801:Humans; D017964:Itraconazole / Q000627:therapeutic use; D008279:Magnetic Resonance Imaging; D008297:Male; D003904:Mitosporic Fungi / Q000302:isolation & purification; D012640:Seizures / Q000382:microbiology*; D014057:Tomography, X-Ray Computed
D000935:Antifungal Agents; D017964:Itraconazole