MR Spectroscopy-aided Differentiation: "giant" Extra-axial Tuberculoma Masquerading As Meningioma

Overview

Journal AJNR Am J Neuroradiol

Specialty Neurology

Date 2006 Aug 16

PMID 16908553

Citations 6

Authors

P C Khanna

S Godinho

D P Patkar

S A Pungavkar

M A Lawande

Affiliations

Soon will be listed here.

Abstract

Tuberculosis is common in the developing world and in developed nations secondary to increasing immunocompromise in the population. It commonly causes meningitis and parenchymal tuberculomas. We present a case of an unusual masslike "giant" extra-axial tuberculoma during pregnancy. Unusual morphology and size at imaging made meningioma a close differential. MR spectroscopy served to complement MR imaging, providing diagnostic confirmation and depicted findings characteristic of a tuberculoma.

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Dural masses: meningiomas and their mimics.

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References

Pretell E, Martinot Jr C, Garcia H, Alvarado M, Bustos J, Martinot C . Differential diagnosis between cerebral tuberculosis and neurocysticercosis by magnetic resonance spectroscopy. J Comput Assist Tomogr. 2005; 29(1):112-4. DOI: 10.1097/01.rct.0000149959.63294.8f. View

Di Patre P, Radziszewski W, Martin N, Brooks A, Vinters H . A meningioma-mimicking tumor caused by Mycobacterium avium complex in an immunocompromised patient. Am J Surg Pathol. 2000; 24(1):136-9. DOI: 10.1097/00000478-200001000-00017. View

Bulakbasi N, Kocaoglu M, Ors F, Tayfun C, Ucoz T . Combination of single-voxel proton MR spectroscopy and apparent diffusion coefficient calculation in the evaluation of common brain tumors. AJNR Am J Neuroradiol. 2003; 24(2):225-33. PMC: 7974143. View

Batra A, Tripathi R . Diffusion-weighted magnetic resonance imaging and magnetic resonance spectroscopy in the evaluation of focal cerebral tubercular lesions. Acta Radiol. 2004; 45(6):679-88. DOI: 10.1080/02841850410001169. View

Filippi C, Edgar M, Ulug A, Prowda J, Heier L, Zimmerman R . Appearance of meningiomas on diffusion-weighted images: correlating diffusion constants with histopathologic findings. AJNR Am J Neuroradiol. 2001; 22(1):65-72. PMC: 7975551. View

Shindo A, Honda C, Baba Y . [A case of an intracranial tuberculoma, mimicking meningioma, that developed during treatment with anti-tuberculous agents]. No Shinkei Geka. 1999; 27(9):837-41. View

Isenmann S, Zimmermann D, Wichmann W, Moll C . Tuberculoma mimicking meningioma of the falx cerebri. PCR diagnosis of mycobacterial DNA from formalin-fixed tissue. Clin Neuropathol. 1996; 15(3):155-8. View

Bauer J, Johnson R, Levy J, Pojman D, Ruge J . Tuberculoma presenting as an en plaque meningioma. Case report. J Neurosurg. 1996; 85(4):685-8. DOI: 10.3171/jns.1996.85.4.0685. View

Gupta R, Husain M, Vatsal D, Kumar R, Chawla S, Husain N . Comparative evaluation of magnetization transfer MR imaging and in-vivo proton MR spectroscopy in brain tuberculomas. Magn Reson Imaging. 2002; 20(5):375-81. DOI: 10.1016/s0730-725x(02)00518-0. View

10.

Gonen O, Murdoch J, Stoyanova R, Goelman G . 3D multivoxel proton spectroscopy of human brain using a hybrid of 8th-order Hadamard encoding with 2D chemical shift imaging. Magn Reson Med. 1998; 39(1):34-40. DOI: 10.1002/mrm.1910390108. View

11.

Adachi K, Yoshida K, Tomita H, Niimi M, Kawase T . Tuberculoma mimicking falx meningioma--case report. Neurol Med Chir (Tokyo). 2004; 44(9):489-92. DOI: 10.2176/nmc.44.489. View

12.

Lindner A, Schneider C, Hofmann E, Soerensen N, Toyka K . Isolated meningeal tuberculoma mimicking meningioma: case report. Surg Neurol. 1995; 43(1):81-3; discussion 83-4. DOI: 10.1016/0090-3019(95)80046-j. View

13.

Gupta R, Pandey R, Khan E, Mittal P, Gujral R, Chhabra D . Intracranial tuberculomas: MRI signal intensity correlation with histopathology and localised proton spectroscopy. Magn Reson Imaging. 1993; 11(3):443-9. DOI: 10.1016/0730-725x(93)90079-s. View