Asymptomatic pulmonary nodules in a patient with early-stage breast cancer: Cryptococcus infection.

In breast cancer patients, pulmonary nodules are frequently considered a metastatic disease or primary lung tumor. We report the case of a 53-year-old woman with early-stage breast cancer (T1micN0M0) presenting with asymptomatic pulmonary nodules in the left upper lobe at follow-up 6 years after she underwent a mastectomy. A presumptive diagnosis of pulmonary metastasis was made, and the patient underwent a video-assisted thoracoscopic lung biopsy. Pathology showed granulomatous inflammation with Cryptococcus infection. Subsequently, antifungal therapy was prescribed, and full recovery followed. We demonstrate the importance of differentiating between pulmonary Cryptococcus infection and metastasis in breast cancer patients for correct management. The relationship between pulmonary Cryptococcus infection and breast cancer is also discussed. Copyright 2009 International Society for Infectious Diseases. Published by Elsevier Ltd. All rights reserved.