Brain Tuberculoma as a Differential Diagnosis of Single Intracranial Lesion: Case Report

Abstract

Tuberculosis (TB) of the central nervous system (CNS) is considered one of the most severe forms of presentation of the disease. Although only 1% of TB cases involve the CNS, these cases represent around between 5 and 15% of extrapulmonary forms.1 2 Tuberculous meningitis (TBM) is the most frequent form of CNS TB. The granulomas formed in the cerebral tuberculoma may cause hydrocephalus and other symptoms indicative of a CNS mass lesion. In the absence of active TB or TBM, the symptoms may be interpreted as indicative of tumors.3 4 The prognosis is directly related to the early diagnosis and proper treatment installation.5 We report the case of a patient with intracranial hypertension syndrome, expansive mass in the parieto-occipital region, accompanied by a lesion in the rib, initially thought to be a metastatic lesion, although posteriorly diagnosed as a cerebral tuberculoma.

Tuberculoma de fosa posterior: una presentación inusual de tuberculosis extrapulmonar

“…El diagnostico de esta patología suele ser un desafío ya que la confirmación suele ser anatomopatológica, usualmente se realiza mediante estudios del líquido cefalorraquídeo, hallazgos en estudios de imagen y manifestaciones clínicas del paciente, que por lo general son sintomatología zonal/regional (dependiendo de las áreas cerebrales afectadas) y alteración del estado de la conciencia, como en nuestro caso. Ya que la biopsia de la lesión intracraneal conlleva a mayor morbimortalidad, se suele dejar únicamente en casos de presentaciones atípicas de tuberculoma [13][14][15] .…”