Meningeal tuberculoma mimicking a brain tumor

Abstract

Meningeal tuberculoma is one of the most serious sites of tuberculosis. Its incidence varies depending on the geographical area, rare in Western countries and frequent in developing countries where it represents 5% to 10% of intracranial masses. We report the case of a 21-year-old male patient with no particular medical history from Africa and living in Europe for more than a year, is hospitalized for an isolated inaugural, generalized, afebrile seizure in whom the scanner and cerebral magnetic resonance imaging (MRI) revealed a meningeal mass with significant glove finger edema suggesting a primary brain tumor. Surgical excision and anatomopathological analysis of the excisional piece allowed the diagnosis of tuberculoma. Meningeal tuberculoma is a source of diagnostic error because its clinical and radiological expression can mimic a brain tumor. This is an etiology that should not be ignored in the face of a meningeal mass in any subject coming from or living in a region with a high endemic tuberculosis.

Meningeal Tuberculoma Masquerading as a Brain Tumor: A Case Report

“…The most common locations are the periventricular gray-white matter junction and posterior fossa. Meningeal-based lesions are rare [ 6 ]. Dural-based lesions or parenchymal lesions that are believed to be originating from dura are termed pachymeningeal TB [ 7 ].…”

“…Medical management is usually pursued with a four-drug regimen with a variable recommended duration of six to nine months or 18 months [ 6 ]. Craniotomy for brain biopsy is also needed for a definitive diagnosis when diagnostic uncertainty exists.…”