IJNS 2016; 05(02): 136-139
DOI: 10.1055/s-0036-1581978
Images in Neurosurgery
Thieme Medical and Scientific Publishers Private Ltd.

Calvarial Tuberculosis Mimicking Meningioma: An Unusual Cause for Aphasia with Scalp Swelling

Raghunath A.
1  Deparment of Neurosurgery, Government T. D. Medical College, Alappuzha, Kerala, India
,
Biju Bhadran
1  Deparment of Neurosurgery, Government T. D. Medical College, Alappuzha, Kerala, India
,
Krishnakumar P.
1  Deparment of Neurosurgery, Government T. D. Medical College, Alappuzha, Kerala, India
,
Sathi P. P.
2  Department of Pathology, Government T. D. Medical College, Alappuzha, Kerala, India
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Publikationsverlauf

12. November 2015

18. Dezember 2015

Publikationsdatum:
08.Juni 2016 (eFirst)

  

Abstract

Background Calvarial tuberculosis is uncommon. It usually presents as a punched out lesion with varying extend of extradural and subgaleal collection. However, typical imaging findings may be lacking and may appear as a neoplasm-like meningioma. This report details the clinical and imaging findings of a left frontal lesion which mimicked neoplasm.

Clinical Presentation A 54-year-old female patient presented with decreased speech output and a gradually growing swelling on the left side of the scalp for 1 year duration. On imaging, lesion was left frontal subgaleal plane and left frontal parenchyma with different signal changes. Bony changes were minimal. Our preoperative diagnosis was a central nervous system tumor-like convexity meningioma with an extracranial growth or a dural-based sarcoma or slow-growing metastasis. The patient underwent left frontal craniotomy and excision of the lesion. Histopathology was suggestive of tuberculous granuloma.

Conclusion Our report represented a case of diffuse variety of calvarial tuberculosis with significant growth into brain parenchyma which is rare. It should be kept as one of the differential diagnosis of lesions with intracranial and scalp component. Awareness will help in managing and prognosticating these lesions.