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

Álvarez-Salgado, J.A.; Ruiz-Gines, J.; Fuentes-Ventura, C.D.; Gonzales-Sejas, A.G.; Diego, J.M. Belinchón de; Mesa, Francisco González-Llanos Fernández de; Lope-Llorca, A. Rodríguez de

doi:10.1016/s1130-1473(11)70118-x

Cited by 2 publications

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References 13 publications

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“…TB can be treated medically after the diagnosis 11) . The diagnosis is established based on the pathology results of a biopsy or detecting M. tuberculosis DNA in a PCR study 2) . Treatment of a tuberculoma is based on anti-TB treatment regimens, which include two important antibiotic agents 10) .…”

Section: Discussionmentioning

confidence: 99%

Radiological Follow-up of a Cerebral Tuberculoma with a Paradoxical Response Mimicking a Brain Tumor

Kim

Jung

Lee

et al. 2015

J Korean Neurosurg Soc

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We report a case of a paradoxical response of a tuberculoma in the brain mimicking a brain tumor. A 76-year-old woman presented with a 2 week history of headache, dysarthia, and orthopnea. Brain magnetic resonance images (MRI) revealed two rim-enhancing lesions on the pons and occipital lobe, and chest computed tomography showed randomly distributed miliary nodules. The tentative diagnosis was tuberculosis (TB) of the brain and lung. She complained of right hemiparesis and worsening general weakness after taking the anti-TB medication. On the monthly follow-up images, the enhanced lesions were enlarged with increased perfusion and choline/creatinine ratio, suggesting a high grade glioma. A surgical resection was completed to diagnose the occipital lesion, and the tuberculoma was pathologically confirmed by a positive TB-polymerase chain reaction. The anti-TB medication was continued for 13 months. A follow-up MRI showed decreased size of the brain lesions associated with perilesional edema, and the clinical symptoms had improved. Brain tuberculoma could be aggravated mimicking brain malignancy during administration of anti-TB medication. This paradoxical response can be effectively managed by continuing the anti-TB drugs.

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Section: Discussionmentioning

confidence: 99%