Table of Contents Author Guidelines Submit a Manuscript
Case Reports in Neurological Medicine
Volume 2011, Article ID 581230, 4 pages
http://dx.doi.org/10.1155/2011/581230
Case Report

Multiple Dural Tuberculomas Presenting as Leptomeningeal Carcinomatosis

Department of Neurosurgery, Uludağ University Medical Faculty, Görükle, 16059 Bursa, Turkey

Received 24 May 2011; Accepted 13 June 2011

Academic Editors: A. Amirjamshidi, J. E. Cohen, N. S. Litofsky, and Y. Wakabayashi

Copyright © 2011 Hasan Kocaeli et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Objective and Importance. We present the rare occurrence of multiple dural-based tuberculomas mimicking leptomeningeal carcinomatosis in a young immunocompetent patient. Clinical Presentation. A 36-year-old man presented with a 2-month history of generalized epileptic activity and altered perception. Neurological examination was remarkable for bilateral Babinski's sign. Cranial magnetic resonance imaging (MRI) revealed multiple dural-based enhancing lesions with cerebral edema. Intervention. A right frontal craniotomy was performed for diagnosis. Histological examination revealed multiple confluent necrotizing and nonnecrotizing granulomas with giant cells which was consistent with tuberculosis (TB), and the patient was placed on anti-TB therapy for 24 months. Conclusion. To the best of our knowledge isolated diffuse involvement of the dura mater by TB, mimicking leptomeningeal carcinomatosis, as the sole manifestation of disease has not been reported before. Since pachymeningeal TB is rarely suspected when atypical radiological appearance is combined with the absence of systemic disease, biopsy is inevitably required for diagnosis.