Intradural extramedullary tuberculoma of the spinal cord mimicking meningioma

BMJ Case Rep. 2022 Dec 9;15(12):e253040. doi: 10.1136/bcr-2022-253040.

Abstract

Intradural extramedullary tuberculoma of the spinal cord is an extremely rare central nervous system tuberculosis manifestation. It is even rarer in patients who have no history of primary tuberculosis. A total of five cases, including the present case of intradural extramedullary tuberculoma without a history of primary tuberculosis, have been reported in the literature. We report a case of a male patient in his 20s who came with progressive weakness in his lower limbs, urinary incontinence and MRI features suggestive of meningioma. The patient underwent a D9-11 laminectomy with total debulking of the tumour. The histopathological examination revealed Langhans-type giant cells, confirming the diagnosis of a tuberculoma. The patient was advised an antitubercular therapy for 18 months. On a follow-up after 1 month, the patient could walk without support and had no urinary incontinence, indicating the importance of prompt surgical resection and adequate antitubercular therapy for a better outcome.

Keywords: Infection (neurology); Neurooncology; Spinal cord; TB and other respiratory infections.

Publication types

  • Case Reports

MeSH terms

  • Antitubercular Agents / therapeutic use
  • Humans
  • Magnetic Resonance Imaging
  • Male
  • Meningeal Neoplasms* / diagnostic imaging
  • Meningeal Neoplasms* / surgery
  • Meningioma* / diagnostic imaging
  • Meningioma* / surgery
  • Spinal Cord Diseases* / diagnosis
  • Tuberculoma* / diagnostic imaging
  • Tuberculoma* / drug therapy

Substances

  • Antitubercular Agents