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Isolated Cerebellar Spindle Cell Pseudotumor Caused by Mycobacterium Avium-Intracellulare Complex in a Patient

Ming-Sheng Lim1, Niamh Bermingham2, Cathal O'Broin3

  • 1Department of Neurosurgery, Cork University Hospital, Cork, Ireland.

World Neurosurgery
|March 2, 2016
PubMed
Abstract

Insights

Spindle cell pseudotumors caused by Mycobacterium avium-intracellulare complex (MAC) infection are rare in non-AIDS patients. This case highlights successful treatment of intracranial MAC with surgery and antimicrobials.

Area of Science:

  • Neurology
  • Infectious Diseases
  • Pathology

Background:

  • Spindle cell pseudotumors are histiocytic lesions typically associated with Mycobacterium avium-intracellulare complex (MAC) infection.
  • These rare tumors are seldom observed in individuals without Acquired Immunodeficiency Syndrome (AIDS).

Observation:

  • A 66-year-old male with a history of sarcoidosis presented with neurological symptoms including neck pain and ataxia.
  • Magnetic resonance imaging revealed a cerebellar lesion, which was surgically removed.
  • Histopathology confirmed a spindle cell pseudotumor, and cerebrospinal fluid cultures isolated MAC.

Findings:

  • Despite negative human immunodeficiency virus (HIV) serology, the patient exhibited CD4 lymphocytopenia.
  • The patient received antimicrobial therapy, including a macrolide.
  • The patient experienced a favorable outcome with no recurrence at 1-year follow-up.

Implications:

  • This case demonstrates a rare instance of isolated intracranial MAC infection presenting as a spindle cell pseudotumor.
  • Successful management involved a combination of surgical resection and targeted antimicrobial treatment.
  • Early diagnosis and intervention are crucial for favorable prognoses in such rare neurological infections.
Keywords:
CerebellumIntracranialMycobacterium avium complexT-lymphocytopenia idiopathic CD4-positive

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