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Spinal intramedullary tuberculoma following pulmonary tuberculosis: A case report and literature review

RATIONALE: Spinal intramedullary tuberculoma (IMTB) is a rare disease that accounts for 1 to 2/100,000 patients with tuberculosis. We presented a case with pulmonary tuberculosis and concurrent IMTB at C3 to C5 level and reviewed the recent case series and discussed the diagnosis, treatment, and out...

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Autores principales: Wang, Guan-Chyuan, Wu, Sheng-Wen
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Wolters Kluwer Health 2017
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5728842/
https://www.ncbi.nlm.nih.gov/pubmed/29245227
http://dx.doi.org/10.1097/MD.0000000000008673
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author Wang, Guan-Chyuan
Wu, Sheng-Wen
author_facet Wang, Guan-Chyuan
Wu, Sheng-Wen
author_sort Wang, Guan-Chyuan
collection PubMed
description RATIONALE: Spinal intramedullary tuberculoma (IMTB) is a rare disease that accounts for 1 to 2/100,000 patients with tuberculosis. We presented a case with pulmonary tuberculosis and concurrent IMTB at C3 to C5 level and reviewed the recent case series and discussed the diagnosis, treatment, and outcome. PATIENT CONCERNS: A 33-year-old male had concurrent pulmonary TB and IMTB at the C3 to C5 level. He had quadriplegia (muscle power 0 at 4 limbs) and sensory loss below C5 level. He also had incontinence, anal tone loss, and paradoxical respiratory pattern. DIAGNOSIS: Spinal magnetic resonance imaging (MRI) showed a 25 11mm intramedullary lesion at C3/C4 level. Under the impression of IMTB, he underwent surgery. INTERVENTION: We performed C3 to C5 laminectomy and en bloc removal of the tumor. The patient kept receiving anti-TB medications after the surgery. OUTCOME: His 4 limbs muscle power had improved but could not be liberated from the endotracheal tube, so tracheostomy was performed. Muscle power gradually increased to 3 points in his upper limbs and to 2 points in his lower limbs. Sensation in his 4 limbs gradually improved as well. LESSONS: IMTB is a rare disease that should be treated with a combination of medication and surgery. For patients with prominent spinal cord compression and neurological symptoms, early operation to remove the tumor is necessary.
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spelling pubmed-57288422017-12-20 Spinal intramedullary tuberculoma following pulmonary tuberculosis: A case report and literature review Wang, Guan-Chyuan Wu, Sheng-Wen Medicine (Baltimore) 7100 RATIONALE: Spinal intramedullary tuberculoma (IMTB) is a rare disease that accounts for 1 to 2/100,000 patients with tuberculosis. We presented a case with pulmonary tuberculosis and concurrent IMTB at C3 to C5 level and reviewed the recent case series and discussed the diagnosis, treatment, and outcome. PATIENT CONCERNS: A 33-year-old male had concurrent pulmonary TB and IMTB at the C3 to C5 level. He had quadriplegia (muscle power 0 at 4 limbs) and sensory loss below C5 level. He also had incontinence, anal tone loss, and paradoxical respiratory pattern. DIAGNOSIS: Spinal magnetic resonance imaging (MRI) showed a 25 11mm intramedullary lesion at C3/C4 level. Under the impression of IMTB, he underwent surgery. INTERVENTION: We performed C3 to C5 laminectomy and en bloc removal of the tumor. The patient kept receiving anti-TB medications after the surgery. OUTCOME: His 4 limbs muscle power had improved but could not be liberated from the endotracheal tube, so tracheostomy was performed. Muscle power gradually increased to 3 points in his upper limbs and to 2 points in his lower limbs. Sensation in his 4 limbs gradually improved as well. LESSONS: IMTB is a rare disease that should be treated with a combination of medication and surgery. For patients with prominent spinal cord compression and neurological symptoms, early operation to remove the tumor is necessary. Wolters Kluwer Health 2017-12-08 /pmc/articles/PMC5728842/ /pubmed/29245227 http://dx.doi.org/10.1097/MD.0000000000008673 Text en Copyright © 2017 the Author(s). Published by Wolters Kluwer Health, Inc. http://creativecommons.org/licenses/by-nc/4.0 This is an open access article distributed under the terms of the Creative Commons Attribution-Non Commercial License 4.0 (CCBY-NC), where it is permissible to download, share, remix, transform, and buildup the work provided it is properly cited. The work cannot be used commercially without permission from the journal. http://creativecommons.org/licenses/by-nc/4.0
spellingShingle 7100
Wang, Guan-Chyuan
Wu, Sheng-Wen
Spinal intramedullary tuberculoma following pulmonary tuberculosis: A case report and literature review
title Spinal intramedullary tuberculoma following pulmonary tuberculosis: A case report and literature review
title_full Spinal intramedullary tuberculoma following pulmonary tuberculosis: A case report and literature review
title_fullStr Spinal intramedullary tuberculoma following pulmonary tuberculosis: A case report and literature review
title_full_unstemmed Spinal intramedullary tuberculoma following pulmonary tuberculosis: A case report and literature review
title_short Spinal intramedullary tuberculoma following pulmonary tuberculosis: A case report and literature review
title_sort spinal intramedullary tuberculoma following pulmonary tuberculosis: a case report and literature review
topic 7100
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5728842/
https://www.ncbi.nlm.nih.gov/pubmed/29245227
http://dx.doi.org/10.1097/MD.0000000000008673
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