Pulmonary cryptococcosis is a fungal infection that mimics metastatic lung tumors. A man with pancreatic head cancer and liver metastases harboring a germline BRCA2 mutation received FOLFOX chemotherapy. Despite a favorable response from the primary tumor and a decline in the CA19-9 levels, a rapidly enlarging solitary pulmonary nodule appeared. Because of the discordance between the response of the primary tumor and the lung nodule, thoracoscopic partial lung resection was performed for a definitive diagnosis, which confirmed pulmonary cryptococcosis. Postoperatively, fluconazole was administered without recurrence and systemic chemotherapy was resumed. Early histopathological confirmation is crucial to make an accurate diagnosis and select the appropriate management.
Keywords: BRCA2 mutation; pancreatic cancer; pulmonary cryptococcosis.