Multiple dural tuberculomas presenting as leptomeningeal carcinomatosis


Kocaeli H., Taşkapılıoğlu M. Ö., Başaran E., Karaoğlu A., Bekar A.

CASE REPORTS IN NEUROLOGICAL MEDICINE, cilt.2011, sa.581230, ss.1-4, 2011 (ESCI)

  • Yayın Türü: Makale / Vaka Takdimi
  • Cilt numarası: 2011 Sayı: 581230
  • Basım Tarihi: 2011
  • Doi Numarası: 10.1155/2011/581230
  • Dergi Adı: CASE REPORTS IN NEUROLOGICAL MEDICINE
  • Derginin Tarandığı İndeksler: Emerging Sources Citation Index (ESCI), Academic Search Premier, Directory of Open Access Journals
  • Sayfa Sayıları: ss.1-4
  • Bursa Uludağ Üniversitesi Adresli: Evet

Özet

Objective and Importance. We present the rare occurrence of multiple dural-based tuberculomas mimicking leptomeningeal carcinomatosis in a young immunocompetent patient. Clinical Presentation. A 36-year-old man presented with a 2-month history of generalized epileptic activity and altered perception. Neurological examination was remarkable for bilateral Babinski's sign. Cranial magnetic resonance imaging (MRI) revealed multiple dural-based enhancing lesions with cerebral edema. Intervention. A right frontal craniotomy was performed for diagnosis. Histological examination revealed multiple confluent necrotizing and nonnecrotizing granulomas with giant cells which was consistent with tuberculosis (TB), and the patient was placed on anti-TB therapy for 24 months. Conclusion. To the best of our knowledge isolated diffuse involvement of the dura mater by TB, mimicking leptomeningeal carcinomatosis, as the sole manifestation of disease has not been reported before. Since pachymeningeal TB is rarely suspected when atypical radiological appearance is combined with the absence of systemic disease, biopsy is inevitably required for diagnosis.