Cerebral chromoblastomycosis complicated by meningitis and multiple fungal aneurysms after resection of a granuloma

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Abstract
Cerebral chromoblastomycosis is a rare intracranial lesion. This lesion was found in a 23-year-old man, who presented with right proptosis and fainting attacks. Computerized tomography revealed a moderately enhanced irregular mass in the right frontal region. Angiography disclosed that the mass was avascular. At surgery, a hard elastic avascular tumor was totally removed piecemeal. Histological diagnosis was a granuloma of fungal origin. Characteristic brown pigments in the hyphae of fungus in the granuloma strongly suggested that the fungus was chromoblastomycosis. The postoperative course was complicated by meningitis and rupture of fungal aneurysms. The patient remained vegetative and died 2 1/2 years later. The literature on such fungal aneurysms is briefly reviewed; no previous case of fungal aneurysms associated with cerebral chromoblastomycosis could be found.