Disseminated Cryptococcal Osteomyelitis Masquerading as Bone Metastases in a Nonhuman Immunodeficiency Virus Patient: A Case Report

This is the authors' abstract. We don't add key points for this paper.

A 71-year-old female presented with a mass on her right index finger. Initial radiographs revealed an eccentric lytic lesion in the proximal phalanx, accompanied by cortical destruction. Magnetic resonance imaging demonstrated a rim-enhanced lesion with extraosseous extension and peripheral marrow edema. Given the presumed diagnosis of metastatic cancer of unknown origin, a nuclear bone scan was performed, revealing increased radiotracer uptake in multiple bones. A surgical excision of the lesion was carried out, and an intraoperative biopsy revealed yellowish pus, from which cultures identified Cryptococcus neoformans . This represents a case of disseminated cryptococcal osteomyelitis masquerading as metastatic cancer. Cryptococcosis typically occurs in patients with immunocompromised conditions or underlying diseases such as end-stage liver disease, renal insufficiency, or malignancy. Diagnosing this condition is challenging; however, prompt identification and initiation of antifungal therapy are crucial. This case report outlines the diagnostic approach and treatment for disseminated skeletal cryptococcosis.