RESUMO
Encephalic abscess and brain metastases management are completely different but their clinical and radiological features can be so similar that differential diagnosis will be extremely difficult. To underline this difficulty, authors report a 50-year-old male patient with nicotine addiction who presented intracranial hypertensive signs and cerebellar syndrome, revealing a cerebellar process diagnosed as tuberculoma. He had antibacillary treatment and corticosteroids with temporarily good recovery and secondary neurological aggravation. He underwent suboccipital craniotomy. Peroperative findings were suggestive of abscess with strong yellow pus. Microbiologic exam did not show any bacterium and histopathological study concluded on a metastases of adenocarcinoma. He died two months later. Infected posterior fossa metastatic tumour can be defined as the presence in the same cerebellar lesion of infectious process and neoplasic metastatic cells. This situation is exceptional with a only a few cases reported in literature. Authors discuss this case along with the few cases reported in literature to approach the pathophysiological mechanisms and diagnostic difficulty of such lesion association, which is generally fatal. We must think to this association in patients with radiographic encephalic findings suggestive of "abscess" to ensure adequate treatment, which may improve prognosis