A Conus Tuberculoma Mimicking an Intramedullary Tumour: A Case Report and Review of the Literature

Abstract

Tuberculomas of the spinal cord are rare. They usually present as mass lesions with little evidence of systemic illness. We report a case where the diagnosis was only made histologically, emphasising the need to consider infection as a cause of neurological illness in patients from under-developed countries.

Treatment of patients with suspected brain tuberculoma before or without bacteriologic confirmation in endemic places: report of two cases

“…It is a chronic bacterial infection identified by the formation of granulomas in the infected tissues [6]. Recent studies report the incidence of tuberculous infection at 11.1 per 100,000 population in Western countries, and neuro-tuberculosis involves 0.5-2 % of extrapulmonary tuberculous infection in the general tuberculosis prevalence [7,8]. The incidence of CNS-TB depends on the incidence of tuberculosis and socioeconomic condition of the country.…”

Intramedullary tuberculoma of the conus medullaris: case report and review of the literature

“…1 Recent statistic reports state the incidence of tuberculous infection at 11.1 per 100 000 population in Western countries and neuro-tuberculosis involves 0.5 to 2% of extra-pulmonary tuberculous infection in the general tuberculosis prevalence. 2,5 Spinal cord involvement is much less common than the brain at a ratio of approximately 1 : 42. 3 This ratio correlates with the spinal cord and brain weight ratio, and their blood supplementation ratio.…”

“…The second form of tuberculoma is one of di use occupation of the subdural masses with a relatively It is reported that patients with intradural extramedullary tuberculoma have presented with a gradual onset over weeks to months with progressive weakness of legs, sometimes associated with sphincter or sensory de®cit. 4,5 A history of past or concurrent tuberculosis exposure to the disease was often obtainable, and patients had frequently su ered from tuberculous meningitis. 3,11,12 Intracerebral tuberculoma are known to occur quite frequently in association with tuberculous meningitis.…”

Intramedullary tuberculoma in a six year old

“…We feel that patients showing radiological increase in the swelling of the cord need not be operated, as this phenomenon could be due to paradoxical response to antituberculous drug therapy and should carefully be followed-up. [11] In conclusion tuberculoma should be considered in the differential diagnosis of all intramedullary space occupying lesions irrespective of age or presence of extracranial focus of tuberculosis in countries endemic to tuberculosis. Most of these patients respond well to anti tuberculous drug therapy with good functional recovery, however, timely surgical decompression in selected cases, provide excellent long-term outcome.…”