Mediastinal cryptococcosis simulating thyroid neoplasia in immunocompetent patient with prior diagnosis and treatment for COPD

We report a case of mediastinal cryptococcosis with thyroid invasion in a patient who presented dry cough and persistent dyspnea. This patient has been treated for COPD, presenting no clinical responses. Spirometry showed fixed flattening of inspiratory and expiratory loops, suggesting extrinsic tracheal compression. A freezing biopsy revealed a mass consisting of lymph nodes and yeasts with characteristics of Cryptococcus spp. After surgical resection of the lesion, the patient was treated with fluconazole, showing total remission of the disease and symptomatology.