Dural Tuberculoma Mimicking Meningioma: A Clinicoradiologic Review of Dural En-Plaque Lesions

En Plaque Tuberculoma: a Case Report

“…However, Srikanteswara et al fossa (6). However, similar imaging findings can be seen in various cases of inflammatory and non-inflammatory conditions, showing dural-based lesions, the most common being meningiomas (5,7). Khanna et al (3) reported a case of MR spectroscopy findings of giant extra-axial tuberculoma.…”

“…An en plaque tuberculoma is a rare entity, first reported in 1927, commonly described as a plaque-like meningitic process without exudation (5). CNS tuberculosis usually results from hematogenous spread.…”

“…Also, when the meningeal inflammation is confined, it forms a macroscopically hard fibrous mass that is attached to the dura without calcification or caseation, and is situated deep in a sulcus in relation to the meninges. The hard fibrous mass is considered to be a likely source of diffuse meningitis and is the result of bacillemia that occurs during the development of the primary lesion or after primary progressive infection (5,6). Radiologic features of en plaque tuberculomas include appearing hyperdense on noncontrast CT scans, isointense to the brain on T1WI, and isointense to hypointense to the brain on T2WI with homogeneous post-contrast enhancement (6, 7).…”

A Missed Differential in an Extra-Axial Lesion with Calvarial Involvement

“…There are a large number of extra-axial lesions that are frequently confused with the commonly encountered meningiomas [1,9]. A few of them show associated focal calvarial erosion.…”

“…Cranial Ewing's sarcoma occurs in the first two decades, commonly involve temporal bone and present as lytic lesion with dural-based and subgaleal soft tissue mass [2]. Dural-based lesion showing T2 hypointense rim and perilesional oedema along with lipid and lactate peaks on MR spectroscopy may provide a clue towards the diagnosis of tuberculoma [9]. …”