case_images: PMC9975338_01
case_images: Post-contrast T1-weighted images showed a right frontal mass with a rugged marginal enhancement and possible extensive interior necrotic change; this was also suggested by the presence of a lactic acid peak on MR spectroscopy.
case_images: fsurg-10-1083833-g001.jpg
case_images: PMC9975338_01_fsurg-10-1083833-g001.jpg
case_images: F1
case_images: Subsequent magnetic resonance imaging (MRI) further delineated a large mass of 53 mm in the right middle frontal lobe with an avid marginal enhancement and central necrosis (Figure 1).
case_images: Diffusion-weighted images showed a right frontal mass without water restriction that differed from the abscess (white arrowhead), and a large area of water restriction in the right frontotemporal lobe, suggesting a massive arterial infarction in the MCA vascular region (black arrowhead).
case_images: fsurg-10-1083833-g002.jpg
case_images: PMC9975338_01_fsurg-10-1083833-g002.jpg
case_images: F2
case_images: Another small lesion of 18 mm in the right caudate head with similar enhancement plus hemorrhaging and diffuse swelling of the right frontal and temporal-occipital lobes was also detected (Figure 2).
case_images: Susceptibility-weighted images showed a mildly increased vascularity in the right frontal mass and a curvilinear dark signal in the right sylvian fissure cistern near the thrombosis of the middle cerebral artery (white arrowhead).
case_images: fsurg-10-1083833-g003.jpg
case_images: PMC9975338_01_fsurg-10-1083833-g003.jpg
case_images: F3
case_images: Right MCA infarction was also apparent on the MRI images (Figure 3).
case_images: Gross appearance of the resected infectious tumor; microscopic section with PAS; and GMS stain showing hyphal formation.
case_images: fsurg-10-1083833-g004.jpg
case_images: PMC9975338_01_fsurg-10-1083833-g004.jpg
case_images: F4
case_images: The patient underwent an emergency craniotomy with en-bloc excision of an elastic solid mass (Figure 4). The pathology report later identified a Cryptococcus infection (Figure 4).