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

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...

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Main Authors: Raghunath A., Biju Bhadran, Krishnakumar P., Sathi P. P.
Format: Article
Language:English
Published: Thieme Medical and Scientific Publishers Pvt. Ltd. 2016-06-01
Series:Indian Journal of Neurosurgery
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Online Access:http://www.thieme-connect.de/DOI/DOI?10.1055/s-0036-1581978
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author Raghunath A.
Biju Bhadran
Krishnakumar P.
Sathi P. P.
author_facet Raghunath A.
Biju Bhadran
Krishnakumar P.
Sathi P. P.
author_sort Raghunath A.
collection DOAJ
description 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.
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language English
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publisher Thieme Medical and Scientific Publishers Pvt. Ltd.
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series Indian Journal of Neurosurgery
spelling doaj-art-8991da6939954bb89aea6806f55d6bd32025-08-20T02:09:37ZengThieme Medical and Scientific Publishers Pvt. Ltd.Indian Journal of Neurosurgery2277-954X2277-91672016-06-01050213613910.1055/s-0036-1581978Calvarial Tuberculosis Mimicking Meningioma: An Unusual Cause for Aphasia with Scalp SwellingRaghunath A.0Biju Bhadran1Krishnakumar P.2Sathi P. P.3Deparment of Neurosurgery, Government T. D. Medical College, Alappuzha, Kerala, IndiaDeparment of Neurosurgery, Government T. D. Medical College, Alappuzha, Kerala, IndiaDeparment of Neurosurgery, Government T. D. Medical College, Alappuzha, Kerala, IndiaDepartment of Pathology, Government T. D. Medical College, Alappuzha, Kerala, IndiaAbstract 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.http://www.thieme-connect.de/DOI/DOI?10.1055/s-0036-1581978calvarial tuberculosiscns tuberculosismeningioma mimic
spellingShingle Raghunath A.
Biju Bhadran
Krishnakumar P.
Sathi P. P.
Calvarial Tuberculosis Mimicking Meningioma: An Unusual Cause for Aphasia with Scalp Swelling
Indian Journal of Neurosurgery
calvarial tuberculosis
cns tuberculosis
meningioma mimic
title Calvarial Tuberculosis Mimicking Meningioma: An Unusual Cause for Aphasia with Scalp Swelling
title_full Calvarial Tuberculosis Mimicking Meningioma: An Unusual Cause for Aphasia with Scalp Swelling
title_fullStr Calvarial Tuberculosis Mimicking Meningioma: An Unusual Cause for Aphasia with Scalp Swelling
title_full_unstemmed Calvarial Tuberculosis Mimicking Meningioma: An Unusual Cause for Aphasia with Scalp Swelling
title_short Calvarial Tuberculosis Mimicking Meningioma: An Unusual Cause for Aphasia with Scalp Swelling
title_sort calvarial tuberculosis mimicking meningioma an unusual cause for aphasia with scalp swelling
topic calvarial tuberculosis
cns tuberculosis
meningioma mimic
url http://www.thieme-connect.de/DOI/DOI?10.1055/s-0036-1581978
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AT bijubhadran calvarialtuberculosismimickingmeningiomaanunusualcauseforaphasiawithscalpswelling
AT krishnakumarp calvarialtuberculosismimickingmeningiomaanunusualcauseforaphasiawithscalpswelling
AT sathipp calvarialtuberculosismimickingmeningiomaanunusualcauseforaphasiawithscalpswelling