Solitary pleural tuberculoma diagnosed by thoracoscopic surgical resection

Tuberculoma is a manifestation of pleural tuberculosis. Although the clinical manifestation of tuberculoma has been widely reported, the pathogenesis of this condition still remains unclear. An abnormal shadow was detected on the chest radiograph of a 44-year-old man with a history of pulmonary tuberculosis. Computed tomography revealed a well-defined, elliptical 44 mm nodule located in the right posterior thoracic cavity. Thoracoscopic surgery was performed to rule out malignant tumors. Although loose adhesions were observed throughout the thoracic cavity, a nodule was found between the visceral pleura and parietal pleura. En bloc resection was performed, and the patient was pathologically diagnosed with tuberculoma. An acid-fast bacterium culture was negative, and the patient's recovery was uneventful without chemotherapy. Surgical resection should be considered to rule out malignancy, because tuberculomas are difficult to distinguish from malignant pleural tumors.