Intracranial en-plaque tuberculoma impersonating en-plaque meningioma: Case report and brief review of literature
Jayendra Kumar1, Jeevesh Mallik2, Ben A Strickland3, Viraat Harsh4, Anil Kumar4
1 Department of Neurosurgery, Narayan Medical College and Hospital, Sasaram, Bihar, India
2 Department of Neurosurgery, Tata Main Hospital, Jamshedpur, Jharkhand, India
3 Department of Neurosurgery, University of Southern California, Los Angeles, California, USA
4 Department of Neurosurgery, Rajendra Institute of Medical Sciences, Ranchi, Jharkhand, India
Department of Neurosurgery, Rajendra Institute of Medical Sciences, Ranchi, Jharkhand - 834 009
Source of Support: None, Conflict of Interest: None
Background: Tuberculosis of the central nervous system continues to be a major health hazard in developing countries like India. There are various manifestations of central nervous system tuberculosis including meningitis and space occupying lesions. We present a case of tuberculoma en-plaque which is often initially confused with a meningioma on presentation. We also review the literature relevant to this unusual entity.
Methods: A search of PubMed, PubMed Central, the Cochrane Library, and MEDLINE were performed to identify all English language reports of intracranial en-plaque tuberculomas. The combinations of text strings “tuberculoma,” “en*,” and “plaque” were used to perform the query on PubMed. Only the studies reporting intracranial en-plaque tuberculomas were included.
Results: Literature review revealed six reports on en-plaque tuberculomas including seven patients. The mean age at presentation was 40.5 years, and no sex predilection was seen. Five of the six reported studies used anti-tuberculous therapy with or without surgical excision of the mass. Most of the patients in reported cases recovered fully.
Conclusion: It is imperative to consider tuberculoma as an important differential when encountering intracranial en-plaque masses as en-plaque tuberculomas can be effectively treated with a combination of anti-tuberculosis therapy and surgical resection, yet consequences of a missed or late diagnosis can prove fatal.