A Rare Case of Pericardial Tuberculoma with Impending Tamponade in a 52-Year Old Woman: A Case Report

Abstract

Pericardial tuberculoma is a rare complication of tuberculous pericarditis. It may mimic a compressive mediastinal mass, often misinterpreted as a mediastinal tumour. Since, it arises from the pericardium, pericardial tuberculoma invariably compresses structures of the heart and may present with features of either-sided heart failure depending on the side of the compression. Hereby, the authors present a case of a 52-year-old woman with progressive difficulty in breathing and symptoms of right-sided heart failure as well as clinical signs of impending cardiac tamponade following a history of extra-pulmonary tuberculosis. Echocardiogram examination revealed a mass compressing the right side of the heart but was inconclusive of the mass origin. CT Scan of the chest showed a mass arising from the pericardium. The mass was later surgically excised. Histopathology confirmed pericardial tuberculosis and a diagnosis of a pericardial tuberculoma was reached. Patient’s heart failure symptoms regressed after surgery and she was discharged to continue with anti-tuberculosis regime. This report discusses the inclusion of pericardial tuberculoma in the differential diagnoses of cardiac compressing masses, particularly in tuberculosis endemic areas and emphasise on prompt CT Scan imaging when echocardiogram is inconclusive.