Intramedullary spinal tuberculoma presenting as a conus tumor: a case report and review of the literature.
Intramedullary spinal tuberculoma is a rare form of central nervous system tuberculosis. Although tuberculosis is unusual in the west, it is still prevalent in Asia and Africa. We report a case in which the diagnosis was made histologically without evidence of symptoms of systemic tuberculosis. The lesion, located in the conus medullaris, mimicked a conus tumor. The patient was a 20-year-old man who presented with a history of progressive leg weakness, urinary urgency, and impotence. There was no history of, or recent contact with, tuberculosis. A diagnosis of an intramedullary tumor in the conus medullaris was made by MRI. The patient underwent a T11-L1 laminectomy and total resection of the lesion with microsurgical technique. Histologic examination revealed a granulomatous lesion containing Langhans' giant cells, inflammatory cells, and caseating necrosis. Antituberculous medication was instituted as soon as the diagnosis was made. Neurologic symptoms and signs slowly improved postoperatively. A combination of microsurgical resection and antituberculous chemotherapy should be the choice of treatment for intramedullary tuberculomas.
Süzer
T
T
Department of Neurosurgery, Pamukkale University School of Medicine, Denizli, Turkey.
Coşkun
E
E
Tahta
K
K
Bayramoğlu
H
H
Düzcan
E
E
D000328:Adult; D000995:Antitubercular Agents / Q000627:therapeutic use; D003937:Diagnosis, Differential; D006801:Humans; D007796:Laminectomy; D008161:Lumbosacral Region; D008279:Magnetic Resonance Imaging; D008297:Male; D008526:Medulla Oblongata; D013118:Spinal Cord Diseases / Q000175:diagnosis* / Q000473:pathology / Q000628:therapy; D013120:Spinal Cord Neoplasms / Q000175:diagnosis*; D014375:Tuberculoma / Q000175:diagnosis* / Q000473:pathology / Q000628:therapy
D000995:Antitubercular Agents