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Case Reports
. 2017 Apr-Jun;8(2):168-170.
doi: 10.1016/j.jcot.2016.06.011. Epub 2016 Jun 22.

Tuberculosis - 'The great masquerader' presenting as a dumb-bell-shaped intradural extramedullary tumor in a 20-year-old female

Mukunth Rajgopalan  1 , Amit Srivastava  1 , Ish K Dhammi  1 , Anil K Jain  1
Affiliations
Case Reports

Tuberculosis - 'The great masquerader' presenting as a dumb-bell-shaped intradural extramedullary tumor in a 20-year-old female

Mukunth Rajgopalan et al. J Clin Orthop Trauma. 2017 Apr-Jun.

Abstract

Tuberculosis has been known as the great masquerader for its varied presentations. We present an extraordinary case of a 20-year-old female who presented with paraparesis of two months. MRI showed an intradural, extramedullary dumb-bell-shaped, spinal cord tumor. With a provisional clinicoradiological diagnosis of benign nerve sheath tumor (schwannoma/neurofibroma), laminectomy was done. But after durotomy, frank pus was drained from the site of lesion and the laboratory investigations of the tissue and pus obtained proved it to be tubercular. This is a rare case reported in the literature where tuberculosis is mimicking as a dumb-bell-shaped, spinal cord tumor.

Keywords: Dumb-bell-shaped tumor; Spine; Tuberculosis.

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Figures

Figs. 1 and 2
Figs. 1 and 2
Seemingly normal plain radiograph; MRI scans showing an ill-defined dumb-bell-shaped lesion on axial section hypointense on T1 and isointense or hyperintense on T2-weighted images, and lesion is extramedullary.
Fig. 3
Fig. 3
The surgical exposure of spine with the thick pus evacuated after incising the dura.
Fig. 4
Fig. 4
Histopathological examination of the resected tissue showed multiple epithelioid cell granuloma with central caseous necrosis suggestive of tuberculosis.
Fig. 5
Fig. 5
Ziehl–Neelsen (ZN) staining of the aspirate was performed and demonstrated acid-fast bacilli, which confirmed tubercular etiology.
See this image and copyright information in PMC

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