1. Home
  2. Vol 18, No 1 (2024)
  3. Gill

Cerebral Tuberculomas Mimicking A Brain Tumor: Report of Two Cases

Arwinder Singh Gill, Muhammad Firdaus, Yosafat Kurniawan Sugiarto, Farilaila Rayhani, Rini Andriani, Ahmad Faried

Abstract


Introduction : Cerebral tuberculoma, a seldom encountered and severe manifestation of tuberculosis (TB), arises from the dissemination of Mycobacterium tuberculosis through the bloodstream. Its symptoms and radiological characteristics lack specificity, often resulting in diagnostic errors. Management predominantly involves medical intervention, with the treatment duration for cerebral tuberculoma ranging from 6 to 36 months. In specific instances, surgical intervention may be advised.

 

Case presentation: We reported two cases of cerebral tuberculoma occurring in patients who presented with seizures, with space-occupying lesions evident on magnetic resonance imaging of the brain. There were no symptoms of concurrent extra cranial TB. Surgery was performed on both of the cases and anti-TB treatment began as soon as the diagnosis was made with corticosteroid as adjuvant treatment.

 

Conclusion: : A combination of clinical, radiological, and histopathological examination is needed to confirm the diagnosis and determine the appropriate therapy. If ICP is increased as a result of the lesion and medical therapy has failed, surgical excision is required.


Keywords


brain tumor, cerebral tuberculoma, tuberculosis, mimicking lesion

Full Text: View | Download

DOI: 10.33371/ijoc.v18i1.1084

Article Metrics

Abstract View: 500,
PDF Download: 192
             

References


Perez-Malagon CD, Barrera-Rodriguez R, Lopez-Gonzalez MA, Alva-Lopez LF. Diagnostic and Neurological Overview of Brain Tuberculomas: A Review of Literature. Cureus. 2021 Dec 3;13(12):e20133

WHO Global. Global Tuberculosis Report 2020 [Internet]. World Health Organization. 2020. Available from: https://www.who.int/publications/i/item/9789240013131

Prihutomo S, Slamet, Rustandi K. Pedoman Nasional Pelayanan Kedokteran Tata Laksana Tuberkulosis. Kementrian Kesehatan Republik Indonesia 2015; 2015.

DeLance AR, Safaee M, Oh MC, et al. Tuberculoma of the central nervous system. J Clin Neurosci. 2013;20(10):1333–41.

Leonard JM. CNS Tuberculosis. In: Microbiol Spectr. 2017. p. 17–44.

Davis AG, Rohlwink UK, Proust A, Figaji AA, Wilkinson RJ. The pathogenesis of tuberculous meningitis. J Leukoc Biol. 2019 Feb;105(2):267-280.

Be N, Kim K, Bishai W, Jain S. Pathogenesis of Central Nervous System Tuberculosis. Curr Mol Med. 2009 Mar 1;9(2):94–9.

Bermudez LE, Sangari FJ. Cellular and molecular mechanisms of internalization of mycobacteria by host cells. Microbes Infect. 2001;3(1):37–42.

Nelson CA, Zunt JR. Tuberculosis of the central nervous system in immunocompromised patients: HIV infection and solid organ transplant recipients. Clin Infect Dis. 2011;53(9):915–26.

Rajeswari R, Sivasubramanian S, Balambal R, et al. A controlled clinical trial of short-course chemotherapy for tuberculoma of the brain. Tuber Lung Dis. 1995;76(4):311–7.

Gregol BM, Berres TO, Barreto T, et al. Brain Tuberculoma as a Differential Diagnosis of Single Intracranial Lesion: Case Report. Arq Bras Neurocir Brazilian Neurosurg. 2020;39(02):142–5.

Moussa AA, Mahmoud ME, Yousef HA. Intracranial tuberculoma and recent advances in magnetic resonance imaging. Egypt J Neurosurg. 2018;33:1–5.

Marais S, Van Toorn R, Chow FC, et al. Management of intracranial tuberculous mass lesions: how long should we treat for? Wellcome Open Res. 2019;4.

Jacobs RF, Sunakorn P, Chotpitayasuno T, et al. Intensive short course chemotherapy for tuberculous meningitis. Pediatr Infect Dis J. 1992;11(3):194–7.


Refbacks

  • There are currently no refbacks.


Creative Commons License
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.