Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Case Reports
. 2015 Oct-Dec;5(4):90-97.

INTRAMEDULLARY TUBERCULOMA OF THORACIC SPINAL CORD IN AN APPARENTLY HEALTHY NIGERIAN: CASE REPORT

A S Yusuf  1 , N A Adeleke  1 , O M Babalola  1 , K W Wahab  2 , L O Oyebanji  3 , A B Ahmed  1 , H K Omokanye  4
Affiliations
Case Reports

INTRAMEDULLARY TUBERCULOMA OF THORACIC SPINAL CORD IN AN APPARENTLY HEALTHY NIGERIAN: CASE REPORT

A S Yusuf et al. J West Afr Coll Surg. 2015 Oct-Dec.

Abstract

Spinal intramedullary is an uncommon form of tuberculosis causing spinal cord injury in this environment. We report a case of thoracic intramedullary tuberculoma in an immunocompetent male Nigerian with negative screening for tuberculosis. He presented with 8 months history of back pain and 2 months history of progressive weakness in both lower limbs. Physical examination revealed a well-nourished man with spastic paraplegia. Chest radiograph and CT scan were normal but Magnetic resonance imaging (MRI) of the thoracolumbar region showed cord oedema and circumscribed intramedullary lesions at D12 and L1 levels with target sign. The patient was promptly prepared and had D12 and L1 laminectomy and posterior myelotomy with excision of the intramedullary lesion. Histology showed granulomatous lesion with central caseation in keeping with a tuberculoma. He was treated with a 4-drug antituberculous regimen with physiotherapy and he made complete neurological recovery 8 months post-operatively. Intramedullary tuberculoma should be considered in differential diagnosis of intramedullary tumors in this environment. Treatment with antituberculous drugs results in good outcome.

Keywords: Good outcome; Immunocompetent patient; Intramedullary spinal tuberculoma.

PubMed Disclaimer

Conflict of interest statement

The authors have declared that no competing interests exist.

Figures

Figure 1
Figure 1. T2 weighted Thoracolumbar MRI of the patient showing circumscribed lesion at D12 and L1 with target sign and spinal cord expansion
Figure 2
Figure 2. Histological appearance of the lesion showing granulomatous lesion with a central area of caseation
See this image and copyright information in PMC

References

    1. Thirunavukarasu SC, Ramachandrappa A. A rare case of intramedullary tuberculoma: Complete resolution after medical treatment and role of magnetic resonance imaging in diagnosis and follow-up. Asian J Neurosurg. 2012;7(4):223–226. - PMC - PubMed
    1. Liu YD, Wang FY, Xu JM, Guan Y, Guan H. Intramedullary thoracic tuberculoma. Spinal cord. 2010;48:80–82. - PubMed
    1. Ju HB, Guo DM, Chen FF. Intramedullary cervical tuberculoma: a case report with note on surgical management. Int Surg. 2015;100(1):133–136. - PMC - PubMed
    1. Mishra SS, Das D, Das S, Mohanta I, Tripathy SR. Spinal cord compression due to primary intramedullary tuberculoma of the spinal cord presenting as paraplegia: A case report and literature review. Surg Neurol Int. 2015;6:42–47. - PMC - PubMed
    1. Murray CJ, Ortblad KF, Guinovart C, Lim SS, Wolock TM, Roberts DA, Vos T. Global, regional, and national incidence and mortality for HIV, tuberculosis, and malaria during 1990-2013: a systematic analysis for the Global Burden of Disease Study 2013. Lancet. 2014;384(9947):1005–1070. - PMC - PubMed

Publication types

LinkOut - more resources