Tuberculosis of the skull mimicking a bony tumor

Asian Journal of Neurosurgery
Fadzlishah Johanabas Rosli, Rahmat Haron

Abstract

We present a rare case of calvarial tuberculosis mimicking a solitary bone tumor, which was surgically removed. A 52-year-old female presented with a right forehead swelling, which gradually enlarged over the course of 2 years, with no symptoms or raised intracranial pressure or neurological deficits. Plain and contrast-enhanced brain computed tomography scans were done, revealing a punched-out lesion of the right frontal bone, with a nonenhancing lytic mass. With an initial diagnosis of an intraosseous meningioma, and later on intraoperatively thought to be a metastatic tumor, the mass was excised along with a rim of bone. Histopathological examination results came back as caseous necrosis, highly suggestive of tuberculosis. The patient was then treated with a 1 year regimen of anti-tuberculous medications. Tuberculosis of the cranium is a rare entity, and can mimic tumors or multiple myeloma. A high index of suspicion and knowledge is required for an early diagnosis. A combined surgical and medical therapy is curative.

Citations

Apr 28, 2019·BMJ Case Reports·Alfredo Manuel Santos Pinheiro da Silva MartinsMelchor Riera Jaume
Mar 9, 2021·Frontiers in Robotics and AI·Arnon Jumlongkul, Panuwat Chutivongse

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