Intramedullary tuberculoma of the spinal cord: a series of 10 cases.
OBJECTIVE
Involvement of vertebral column is common in tuberculosis but intramedullary tuberculomas are rare. We report a series of ten cases of intramedullary tuberculomas, which, to the best of our knowledge, is the largest series of biopsy proven intramedullary tuberculomas in English literature.


METHODS
During a period of 16 years (1985-2000), ten cases of intramedullary tuberculomas were diagnosed in our department. Of these, eight cases were histologically proven intramedullary tuberculomas. The clinical profile, radiological data and histological slides were reviewed.


RESULTS
Age ranged from 18 to 45 years (mean 29.7 years) and there was slight male preponderance (six men, four women). Duration of symptom varied from 3 to 20 months (mean 11.5 months). All of them presented with motor weakness and sensory impairment. Most common site of involvement was dorsal cord followed by cervical, cervicodorsal and dorsolumbar regions. Three patients had associated involvement of lungs, cervical lymphnodes, and brain, and one patient had past history of tuberculous meningitis. Two patients were treated conservatively but surgical excision was done in eight cases followed by medical treatment.


CONCLUSIONS
Radiologically, intramedullary tuberculomas should be differentiated from other space occupying lesions (SOL) to avoid unnecessary surgery especially in those patients with tuberculosis of the other organs. The incidence of intramedullary tuberculomas is likely to increase with a rise in the incidence of AIDS.
Department of Pathology, All India Institute of Medical Sciences, Ansari Nagar, 110 029, New Delhi, India.
M C
MC
Sharma
R
R
Arora
P S
PS
Deol
A K
AK
Mahapatra
A K
AK
Sinha
C
C
Sarkar
D000293:Adolescent; D000328:Adult; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D018908:Muscle Weakness / Q000209:etiology; D011859:Radiography; D012189:Retrospective Studies; D012678:Sensation Disorders / Q000209:etiology; D013118:Spinal Cord Diseases / Q000000981:diagnostic imaging / Q000473:pathology* / Q000601:surgery; D014375:Tuberculoma / Q000000981:diagnostic imaging / Q000473:pathology* / Q000601:surgery