Pulmonary cryptococcoma is an unusual disease in immunocompetent patients. The typical radiologic findings are single or multiple small nodules. We describe a case of a large pulmonary cryptococcoma in a 69-year-old patient, who presented with generalized weakness and poor appetite. Computed tomography of the chest showed a large mass that was strongly suggestive of lung cancer. Pulmonary cryptococcal infection was diagnosed by transthoracic needle biopsy. Human immunodeficiency virus testing was negative. The mass resolved with 200 mg daily of oral fluconazole over the course of 6 months.
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