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Granulomatous brain tumor caused by Acanthamoeba. Case report
Journal of Neurosurgery
|March 1, 1986
Summary
Acanthamoeba infection presented unusually as a brain tumor in a child, not typical meningoencephalitis. Surgical removal and ketoconazole led to a full recovery, highlighting a novel presentation and treatment approach.
Area of Science:
- Neurology
- Infectious Diseases
- Pathology
Background:
- Acanthamoeba species are ubiquitous protozoa capable of causing severe central nervous system infections, primarily as diffuse meningoencephalitis or chorioretinitis.
- While Acanthamoeba infections are well-documented, presentation as a discrete brain tumor is exceptionally rare, posing diagnostic challenges.
Observation:
- A previously healthy 7-year-old girl developed a left frontoparietal tumor.
- Imaging revealed a discrete mass, atypical for common pediatric brain tumors and distinct from typical Acanthamoeba meningoencephalitis presentations.
- The mass was surgically excised, and histopathology confirmed it as an Acanthamoeba-induced granuloma.
Findings:
- The patient's Acanthamoeba central nervous system infection manifested as a focal granulomatous mass, lacking diffuse encephalitis or meningeal enhancement.
- Microscopic examination identified Acanthamoeba trophozoites and cysts within the granulomatous tissue.
- Post-operative treatment with ketoconazole was administered.
Implications:
- This case expands the spectrum of clinical presentations for Acanthamoeba CNS infections, emphasizing the possibility of a tumor-like mass.
- Early and accurate diagnosis through biopsy is crucial for appropriate management.
- Successful treatment with surgical excision and antifungal therapy suggests a potentially favorable prognosis for this rare presentation.