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Spinal epidural tuberculoma with osseous involvement: illustrative case
BACKGROUND: A tuberculosis infection of the central nervous system can present as a localized, intraspinal tuberculoma. These lesions may cause spinal cord compression requiring early identification and surgical decompression to limit deleterious neurological sequelae. OBSERVATIONS: A 28-year-old fe...
Autores principales: | , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
American Association of Neurological Surgeons
2023
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10550642/ https://www.ncbi.nlm.nih.gov/pubmed/36916527 http://dx.doi.org/10.3171/CASE22376 |
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author | Cannon, Hershel W. Weaver, Michael Kaul, Anand Lazim, Ahmed |
author_facet | Cannon, Hershel W. Weaver, Michael Kaul, Anand Lazim, Ahmed |
author_sort | Cannon, Hershel W. |
collection | PubMed |
description | BACKGROUND: A tuberculosis infection of the central nervous system can present as a localized, intraspinal tuberculoma. These lesions may cause spinal cord compression requiring early identification and surgical decompression to limit deleterious neurological sequelae. OBSERVATIONS: A 28-year-old female with a history of opioid use disorder presented with low-back pain in the setting of trauma with progressive bilateral lower extremity radiculopathy and paraparesis. T1- and T2-weighted magnetic resonance imaging sequences of the spine demonstrated a heterogeneously hyperintense extra-axial epidural mass at T11 with mass effect. Biopsy of the lesion revealed benign soft tissue with necrosis and caseating granulomatous inflammation consistent with tuberculoma. The patient underwent laminectomy and debulking of mass for decompression and was subsequently began antitubercular treatment with good neurological outcome. LESSONS: To the best of the authors’ knowledge, there are only a handful of microbiologically and radiographically confirmed cases of spinal epidural tuberculoma in English literature. These lesions are rare and difficult to clinically and radiographically characterize in the absence of systemic pulmonary TB symptoms. Tuberculoma is an important differential for a spinal epidural mass, particularly because resection with systemic antitubercular treatment results in symptom resolution. |
format | Online Article Text |
id | pubmed-10550642 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2023 |
publisher | American Association of Neurological Surgeons |
record_format | MEDLINE/PubMed |
spelling | pubmed-105506422023-10-06 Spinal epidural tuberculoma with osseous involvement: illustrative case Cannon, Hershel W. Weaver, Michael Kaul, Anand Lazim, Ahmed J Neurosurg Case Lessons Case Lesson BACKGROUND: A tuberculosis infection of the central nervous system can present as a localized, intraspinal tuberculoma. These lesions may cause spinal cord compression requiring early identification and surgical decompression to limit deleterious neurological sequelae. OBSERVATIONS: A 28-year-old female with a history of opioid use disorder presented with low-back pain in the setting of trauma with progressive bilateral lower extremity radiculopathy and paraparesis. T1- and T2-weighted magnetic resonance imaging sequences of the spine demonstrated a heterogeneously hyperintense extra-axial epidural mass at T11 with mass effect. Biopsy of the lesion revealed benign soft tissue with necrosis and caseating granulomatous inflammation consistent with tuberculoma. The patient underwent laminectomy and debulking of mass for decompression and was subsequently began antitubercular treatment with good neurological outcome. LESSONS: To the best of the authors’ knowledge, there are only a handful of microbiologically and radiographically confirmed cases of spinal epidural tuberculoma in English literature. These lesions are rare and difficult to clinically and radiographically characterize in the absence of systemic pulmonary TB symptoms. Tuberculoma is an important differential for a spinal epidural mass, particularly because resection with systemic antitubercular treatment results in symptom resolution. American Association of Neurological Surgeons 2023-03-13 /pmc/articles/PMC10550642/ /pubmed/36916527 http://dx.doi.org/10.3171/CASE22376 Text en © 2023 The authors https://creativecommons.org/licenses/by-nc-nd/4.0/CC BY-NC-ND 4.0 (http://creativecommons.org/licenses/by-nc-nd/4.0/ (https://creativecommons.org/licenses/by-nc-nd/4.0/) ). |
spellingShingle | Case Lesson Cannon, Hershel W. Weaver, Michael Kaul, Anand Lazim, Ahmed Spinal epidural tuberculoma with osseous involvement: illustrative case |
title | Spinal epidural tuberculoma with osseous involvement: illustrative case |
title_full | Spinal epidural tuberculoma with osseous involvement: illustrative case |
title_fullStr | Spinal epidural tuberculoma with osseous involvement: illustrative case |
title_full_unstemmed | Spinal epidural tuberculoma with osseous involvement: illustrative case |
title_short | Spinal epidural tuberculoma with osseous involvement: illustrative case |
title_sort | spinal epidural tuberculoma with osseous involvement: illustrative case |
topic | Case Lesson |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10550642/ https://www.ncbi.nlm.nih.gov/pubmed/36916527 http://dx.doi.org/10.3171/CASE22376 |
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