title: Intramedullary spinal tuberculoma--case report.
abstract: A healthy 33-year-old man presented with an intramedullary tuberculoma of the thoracic spinal cord manifesting as a 2-month history of progressive paraparesis and sphincter dysfunction. Magnetic resonance imaging showed ring enhancement of the intramedullary thoracic lesion with perifocal edema. General physical examination was unremarkable with no signs of inflammation except for a positive finding by the tuberculin skin test. Total resection of the intramedullary mass was performed through a posterior myelotomy following T11-12 laminectomy. Histological examination revealed a granulomatous lesion that contained Langhans giant cells, inflammatory cells, and caseating necrosis. Acid-fast bacilli staining of the specimens was positive, and cultures grew Mycobacterium tuberculosis. Postoperatively, the paraparesis and sphincter dysfunction improved sufficiently for the patient to return to his ordinary activities. Intramedullary spinal tuberculoma is rare, but must be considered in the differential diagnosis of spinal cord compression.
authors.affiliation: Department of Neurosurgery, Kohnan Hospital, Sendai, Miyagi, Japan.
authors.forename: Hiroaki
authors.initials: H
authors.lastname: Torii
authors.forename: Toshiyuki
authors.initials: T
authors.lastname: Takahashi
authors.forename: Hiroaki
authors.initials: H
authors.lastname: Shimizu
authors.forename: Mika
authors.initials: M
authors.lastname: Watanabe
authors.forename: Teiji
authors.initials: T
authors.lastname: Tominaga
mesh_terms: D000328:Adult; D006801:Humans; D008297:Male; D013118:Spinal Cord Diseases / Q000175:diagnosis* / Q000601:surgery; D013904:Thoracic Vertebrae; D014375:Tuberculoma / Q000175:diagnosis* / Q000601:surgery; D020306:Tuberculosis, Central Nervous System / Q000175:diagnosis* / Q000601:surgery