Coexistence between meningioma and tuberculosis: case report

Area of Science:

• Neurology
• Pathology
• Oncology

Background:

• Intracranial tuberculomas typically manifest as ring-enhancing lesions in the brain parenchyma.
• Meningiomas are common primary brain tumors, often benign.
• Metastatic disease is a frequent cause of ring-enhancing brain lesions.

Observation:

• A 66-year-old female with a history of breast cancer and rheumatoid arthritis presented with neurological symptoms including headache, nausea, and memory loss.
• Computed tomography (CT) scan revealed an occipital lesion with contrast enhancement and surrounding edema, suggestive of metastasis.
• Histological examination of the resected lesion showed a benign meningioma with granulomas and caseating necrosis, alongside features of tuberculosis.

Findings:

• The case presented an unusual coexistence of an occipital meningioma and intracranial tuberculosis within the same anatomical region.
• The combined pathology presented radiologically as a single, enhancing lesion with edema, closely resembling metastatic carcinoma.
• Histological analysis confirmed both a benign meningioma and tuberculous inflammation.

Implications:

• This case underscores the importance of considering infectious etiologies, such as tuberculosis, in the differential diagnosis of ring-enhancing brain lesions, even in patients with a history of malignancy.
• The simultaneous presence of meningioma and tuberculoma can pose significant diagnostic challenges, necessitating thorough histopathological evaluation.
• Accurate diagnosis is crucial for appropriate treatment and management of patients with complex intracranial pathologies.