[A Case of Cerebral Tuberculoma]

Area of Science:

• Neurology
• Infectious Diseases
• Radiology

Background:

• Cerebral tuberculoma is a rare but severe manifestation of tuberculosis.
• Diagnosis is challenging due to nonspecific imaging and clinical findings, often mimicking brain tumors.
• A history of treated pulmonary tuberculosis does not exclude the possibility of recurrence or new central nervous system involvement.

Observation:

• A 56-year-old woman presented with headaches, a history of successfully treated pulmonary TB.
• Brain MRI showed an enhanced right frontal lobe mass with edema, suggestive of a tumor.
• Elevated carcinoembryonic antigen (CEA) and moderate FDG uptake on PET scans indicated inflammation or malignancy.

Findings:

• Despite nonspecific initial findings, surgical removal and pathological examination confirmed cerebral tuberculoma.
• The lesion was initially indistinguishable from a primary brain tumor.
• Mildly elevated CEA and moderate FDG uptake were consistent with intracranial inflammation.

Implications:

• Cerebral tuberculoma must be included in the differential diagnosis of intracranial mass lesions in patients with a history of TB.
• Even after complete cure of the primary TB lesion, recurrence or new CNS involvement is possible.
• Integrated diagnostic approaches considering patient history and subtle imaging markers are vital for timely diagnosis.