Background: Spindle cell pseudotumors are formed by histiocytes in response to infection by Mycobacterium avium-intracellulare complex (MAC) and are rare in patients without AIDS.
Case description: A 66-year-old man presented with neck pain, ataxia, and a history of sarcoidosis. A cerebellar lesion was identified on magnetic resonance imaging and surgically excised. Histopathology revealed this to be a spindle cell pseudotumor and MAC was isolated by bacterial culture of cerebrospinal fluid. Hematology revealed cluster of differentiation 4 lymphocytopenia but human immunodeficiency virus serology was negative. The patient was commenced on antimicrobial treatment that included a macrolide and remained well at 1 year follow-up.
Conclusions: This rare presentation of isolated intracranial MAC was treated with surgical excision and antimicrobials with a good outcome.
Keywords: Cerebellum; Intracranial; Mycobacterium avium complex; T-lymphocytopenia idiopathic CD4-positive.
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