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INTRAMEDULLARY TUBERCULOMA OF THORACIC SPINAL CORD IN AN APPARENTLY HEALTHY NIGERIAN: CASE REPORT
*1Yusuf AS, 1Adeleke NA, 1Babalola OM, 2Wahab KW, 3Oyebanji LO, 1Ahmed AB, *Omokanye HK4Departments of 1Surgery, 2Medicine, 3Radiology & 4Otorhinolaryngology, University of Ilorin Teaching Hospital, Ilorin, Nigeria.
Email: habeebomokanye@yahoo.com
*Correspondence
Grant support: None
Conflict of Interest: None
ABSTRACT
Background: Spinal intramedullary is an uncommon form of tuberculosis causing spinal cord injury in this environment. We report a case of thoracic intramedullary tuberculoma in an immunocompetent male Nigerian with negative screening for tuberculosis. He presented with 8 months history of back pain and 2 months history of progressive weakness in both lower limbs. Physical examination revealed a well-nourished man with spastic paraplegia. Chest radiograph and CT scan were normal but Magnetic resonance imaging (MRI) of the thoracolumbar region showed cord oedema and circumscribed intramedullary lesions at D12 and L1 levels with target sign. The patient was promptly prepared and had D12 and L1 laminectomy and posterior myelotomy with excision of the intramedullary lesion. Histology showed granulomatous lesion with central caseation in keeping with a tuberculoma. He was treated with a 4-drug antituberculous regimen with physiotherapy and he made complete neurological recovery 8 months post-operatively.
Intramedullary tuberculoma should be considered in differential diagnosis of intramedullary tumors in this environment. Treatment with antituberculous drugs results in good outcome.
Keywords: Intramedullary spinal tuberculoma, Immunocompetent patient, Good outcome.
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