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Isolated extradural tuberculous granuloma of the cervical spine: a case report

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Abstract

Introduction

Isolated intraspinal extradural tuberculous granuloma (IETG) without radiological evidence of vertebral involvement is uncommon, especially rare in cervical spine.

Materials and methods

We report a case of cervical IETG without bone involvement in a patient with neurological deficit. The patient suffered from progressive neurological dysfunction. MRI of cervical spine revealed an intraspinal extradural mass, and the spinal cord was edematous because of the compression. Thus C2–C4 laminectomy was performed and extradural mass was excised.

Results

The excised extradural mass was confirmed to be tuberculous granuloma through pathologic examination. Antituberculous drugs were administrated with a regular follow-up. Excellent clinical outcomes were achieved.

Conclusions

The isolated IETG, although a rare entity, should be considered in the differential diagnosis of the intraspinal mass, especially in patients with spinal cord compression and a history of tuberculosis. If there is a progressing neurological deficit, a combination of surgical and anti-tuberculous treatment should be the optimal choice.

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References

  1. Davidson PT, Horowitz I (1970) Skeletal tuberculosis—A review with patient presentations and discussion. Am J Med 48:77

    Google Scholar 

  2. Hsu LCS, Leong JCY (1984) Tuberculosis of the lower cervical-spine (C2–C7)—A report on 40 cases. J Bone Joint Surg Br 66:1–5

    PubMed  CAS  Google Scholar 

  3. Arseni C, Samitca DCT (1960) Intraspinal tuberculous granuloma. Brain 83:285

    Google Scholar 

  4. Mantzoros CS, Brown PD, Dembry L (1993) Extraosseous epidural tuberculoma—Case report and review. Clin Infect Dis 17:1032–1036

    Article  PubMed  CAS  Google Scholar 

  5. Reichenthal E, Cohen ML, Shalit MN (1981) Extraosseous extradural tuberculous granuloma of the cervical-spine—A case report and review of intraspinal granulomatous infections. Surg Neurol 15:178–181

    Article  PubMed  CAS  Google Scholar 

  6. Kayaoglu CR, Tuzun Y, Boga Z, Erdogan F, Gorguner M, Aydin IH (2000) Intramedullary spinal tuberculoma—A case report. Spine 25:2265–2268

    Article  PubMed  CAS  Google Scholar 

  7. Davies PDO, Humphries MJ, Byfield SP, Nunn AJ, Darbyshire JH, Citron KM, Fox W (1984) Bone and joint tuberculosis—A survey of notifications in England and Wales. J Bone Joint Surg Br 66:326–330

    PubMed  CAS  Google Scholar 

  8. Harada Y, Tokuda O, Matsunaga N (2008) Magnetic resonance imaging characteristics of tuberculous spondylitis versus. pyogenic spondylitis. Clin Imag 32:303–309

    Article  Google Scholar 

  9. Tali ET (2004) Spinal infections. Eur J Radiol 50:120–133

    Article  PubMed  Google Scholar 

  10. Rajasekaran S, Shanmugasundaram TK, Prabhakar R, Dheenadhayalan J, Shetty AP, Shetty DK (1998) Tuberculous lesions of the lumbosacral region—A 15-year follow-up of patients treated by ambulant chemotherapy. Spine 23:1163–1167

    Article  PubMed  CAS  Google Scholar 

  11. Watts HG, Lifeso RM (1996) Tuberculosis of bones and joints. J Bone Joint Surg Am 78A:288–298

    Google Scholar 

  12. Kumar S, Jain AK, Dhammi IK, Aggarwal AN (2007) Treatment of intraspinal tuberculoma. Clin Orthop Relat R:62–66

    Google Scholar 

  13. Shah A, Nadkarni T, Goel N, Goel A (2010) Circumferential craniocervical extradural tuberculous granulations. J Clin Neurosci 17:808–809

    Article  PubMed  Google Scholar 

  14. Narlawar RS, Shah JR, Pimple MK, Patkar DP, Patankar T, Castillo M (2002) Isolated tuberculosis of posterior elements of spine: magnetic resonance imaging findings in 33 patients. Spine (Phila Pa 1976) 27:275–281

    Article  Google Scholar 

  15. Acharya S, Ratra GS (2006) Posterior spinal cord compression—Outcome and results. Spine 31:E574–E578

    Article  PubMed  Google Scholar 

  16. Turgut M (2001) Multifocal extensive spinal tuberculosis (Pott’s disease) involving cervical, thoracic and lumbar vertebrae. Brit J Neurosurg 15:142–146

    Article  CAS  Google Scholar 

  17. Zemmoura I, Hamlat A, Morandi X (2011) Intradural extramedullary spinal inflammatory myofibroblastic tumor: case report and literature review. Eur Spine J 20(Suppl 2):S330–S335

    Article  PubMed  Google Scholar 

  18. Nussbaum ES, Rockswold GL, Bergman TA, Erickson DL, Seljeskog EL (1995) Spinal tuberculosis—A diagnostic and management challenge. J Neurosurg 83:243–247

    Article  PubMed  CAS  Google Scholar 

  19. Tureyen K (2002) Tuberculoma of the conus medullaris: case report. Neurosurgery 50:651–652

    Article  PubMed  Google Scholar 

  20. Jain AK (2010) Tuberculosis of the spine-A fresh look at an old disease. J Bone Joint Surg Br 92B:905–913

    Google Scholar 

Download references

Acknowledgments

The authors are grateful to the pathological data of the patient provided by the Department of Pathology of our Hospital.

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Correspondence to Yong Qiu.

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Ding, Q., Liu, Z., Sun, X. et al. Isolated extradural tuberculous granuloma of the cervical spine: a case report. Eur Spine J 21 (Suppl 4), 467–470 (2012). https://doi.org/10.1007/s00586-011-2095-9

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  • DOI: https://doi.org/10.1007/s00586-011-2095-9

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