Pulmonary cryptococcosis mimicking metastatic progression despite systemic disease stability in advanced colon cancer: A case report and literature review.
Yu-Cai Jiang, Bi-Jin Zheng, Ming-Gui Fu et al.
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Case in brief
A patient with advanced colon cancer undergoing chemotherapy presented with new pulmonary nodules on imaging, despite stable systemic disease and declining tumor markers. Initially suspected to be metastatic progression, further evaluation revealed positive tests for pulmonary cryptococcosis. Treatment with fluconazole was initiated, leading to marked regression of the lung nodules on follow-up imaging.
Diagnostic / clinical pearl
Clinicians should consider opportunistic infections like cryptococcosis when new pulmonary nodules appear in patients with stable cancer, as this can prevent misinterpretation of imaging findings as metastatic progression.
Why it matters
This case highlights the importance of integrating clinical stability, imaging results, and targeted testing to avoid unnecessary treatment escalation in cancer patients.