Cai Yuankun, Wu Qian, Wu Xiaohui, Liu Zheng
Department of Neurosurgery, Zhongnan Hospital of Wuhan University, 169#, Donghu Road, Wuhan, 430071, PR China.
Heliyon. 2022 Dec 30;9(1):e12761. doi: 10.1016/j.heliyon.2022.e12761. eCollection 2023 Jan.
We report a rare case of concurrent pulmonary and cerebral mucormycosis initially misdiagnosed as a metastatic tumor. A 66-year-old man with a complaint of progressive right-sided limb weakness for 3 days. Head MRI showed a left parietal occupying lesion with severe edema, and a chest CT scan showed a parenchymal mass with speculation and pleural invasion in his left lung. The patient was initially diagnosed with brain metastases from lung cancer and underwent a craniotomy. Many fungal hyphae were found in the left parietal lesion, and the final pathological diagnosis of intracranial mucormycosis. After craniotomy and an entire course of treatment with liposomal amphotericin B, the patient was completely cured of both intracranial and pulmonary occupying lesions. We hope that this case experience will help expand neurosurgeons' differential diagnosis and treatment of such diseases.
我们报告一例罕见的同时发生肺部和脑部毛霉病的病例，最初被误诊为转移性肿瘤。一名66岁男性，主诉右侧肢体进行性无力3天。头部MRI显示左侧顶叶占位性病变伴严重水肿，胸部CT扫描显示左肺实质肿块伴毛刺和胸膜侵犯。患者最初被诊断为肺癌脑转移并接受了开颅手术。在左侧顶叶病变中发现许多真菌菌丝，最终病理诊断为颅内毛霉病。经过开颅手术和脂质体两性霉素B全程治疗后，患者颅内和肺部占位性病变均完全治愈。我们希望这个病例经验将有助于扩大神经外科医生对此类疾病的鉴别诊断和治疗。
