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Optic pathways tuberculoma mimicking glioma: case report
Antonio Aversa do Souto1, Ana Luiza V Fonseca, Mônica Gadelha
1Division of Neurosurgery, University Hospital-Federal University of Rio de Janeiro, Rio de Janeiro, Brazil.
Surgical Neurology
|September 25, 2003
Summary
Optochiasmatic tuberculomas are rare, presenting as optic pathway lesions that can mimic gliomas. Histopathology is crucial for diagnosing these rare tuberculosis manifestations, even without systemic signs.
Area of Science:
- Neuro-ophthalmology
- Neuropathology
- Infectious Diseases
Background:
- Optochiasmatic tuberculomas are rare, potentially presenting as the sole manifestation of tuberculosis.
- These lesions can mimic optic pathway gliomas on imaging.
- Tuberculous involvement of the optic pathways can lead to visual compromise.
Observation:
- A case of a 20-year-old male with bilateral amaurosis, diabetes insipidus, and panhypopituitarism is presented.
- Imaging revealed an optochiasmatic lesion extending to optic nerves, resembling an optic pathway glioma.
- Histopathology confirmed a granulomatous lesion with acid-fast bacilli.
Findings:
- The patient underwent surgical exploration and biopsy.
- Histopathological examination revealed granulomatous inflammation with caseous necrosis and acid-fast bacilli.
- Despite treatment with tuberculostatic drugs, vision recovery was not achieved.
Implications:
- This case highlights the importance of considering tuberculomas in the differential diagnosis of optochiasmatic lesions, especially when they mimic gliomas.
- Histopathological confirmation is essential for accurate diagnosis and appropriate treatment of intrinsic optochiasmatic region processes.
- Extensive optic pathway involvement by tuberculoma, as seen in this case, poses diagnostic challenges.