A Meningioma-Mimicking Tumor Caused by Mycobacterium avium Complex in an Immunocompromised Patient

Abstract

Intracranial tuberculomas manifesting radiologically as typical dural-based "meningiomas" have been reported, most frequently in immunosuppressed patients. Their incidence is high in developing countries; they are only sporadically observed in Western Europe and North America, usually in patients with acquired immunodeficiency syndrome (AIDS). According to published reports, intracranial tuberculomas are always due to infection by Mycobacterium tuberculosis. We report a case of a 50-year-old woman with systemic lupus erythematosus (SLE) who presented with a dural based, meningioma-like mass in the right frontal region, resulting from a localized infection by Mycobacterium avium complex. Histologically, the mass resembled a meningioma in being composed of spindly cells arranged in a fascicular pattern. Immunohistochemical stains showed this tumor to consist of a large aggregate of AFB-laden histiocytes without caseating necrosis or multinucleated giant cells.

Tuberculoma intracraneal simulando neoplasia maligna: Caso clinico y revision de la literatura

“…Las secuencias de imagen por difusión y espectroscopía también pueden ser útiles en la identificación de los distintos componentes de la lesión, mostrando por lo general un pico elevado de lípidos 15 . Los tuberculomas con un patrón de crecimiento con implantación dural son raros y aquellos descritos tienen características radiológicas similares a los meningiomas con extensión transcraneal 5 . La paciente que presentamos es un caso inusual debido a la presentación insidiosa con trastorno del comportamiento y datos de hipertensión intracraneal.…”

Tuberculoma intracraneal simulando neoplasia maligna. Caso clinico y revision de la literatura

“…Los tuberculomas con un patrón de crecimiento con implantación dural son raros y aquellos descritos tienen características radiológicas similares a los meningiomas con extensión transcraneal 5 . La paciente que presentamos es un caso inusual debido a la presentación insidiosa con trastorno del comportamiento y datos de hipertensión intracraneal.…”

Tuberculoma of the cavernous sinus mimicking a meningioma: Case report and review of the literature

“…In computed tomography scans, tuberculoma appears as a low or high density mass, round or mutilobular, with homogeneous or ring enhancement after contrast agent injection [3,12]. Most tuberculomas appear hypointense to isointense to gray matter [14][15][16][17][18][19] on T1WI and T2WI and variable on DWI, often with a hypointense rim in T2WI [20]; those with hyperintense centers on T2WI are usually hyperintense on DWI. [21] Meningiomas typically appear isointense to gray matter on T1WI and T2WI and DWI, unless atypical or aggressive.…”