肿瘤外科档案

Multiple Isolated Intracranial Tuberculomas Masquerading as Brain Metastases on Radiological Imaging: Success of a Therapeutic Trial

Abstract

Junaid Nabi

Tuberculosis is endemic in Bangladesh. It remains a resilient public health concern. Reports on presentation and management of intracranial tuberculoma from Bangladesh are sparse. Despite being potentially remediable, tuberculomas are still a cause of significant morbidity and mortality in developing nations. Intracranial tuberculomas can occur as solitary or multiple lesions. Multiple isolated intracranial tuberculomas are rare, and difficult to discern from brain metastases. A unique case of intracranial tuberculomas is presented, which masqueraded as brain metastases on imaging studies and was diagnosed and treated with a trial of antitubercular chemotherapy. A 43-year-old Bengali male presented to the OPD with headaches and blurring of vision for four months. He was provided symptomatic treatment at his regional hospital, which did not abate his condition and was later referred to our center when he developed severe vomiting. Routine investigations including chest radiograph were clean. CT scan showed bilateral edema in cerebral hemispheres and MRI revealed rounded signal change areas of right frontal lobe and left parietal lobe posteriorly, strongly suggestive of brain metastases. Patient declined biopsy. In view of his past history, a full course of antitubercular chemotherapy was prescribed. Following the medication, patient’s condition improved and at 24 months follow-up, there was complete resolution of the lesion.