Adrenal Tuberculoma about a Case

Abstract

Introduction The patient was K.Z, 44 years old. Clinically, he presented with right flank pain that had been developing paroxysm for 6 months in a context of altered general condition. The radiological work-up (ultrasound and CT scan) concluded to a well-limited right adrenal mass with low tissue density and low enhancement after injection of the contrast medium. Endocrinological investigations were negative, including a synacthen test. An adrenal MRI showed a 3 cm right adrenal nodule suggestive of a non-secreting adenoma. The treatment was lumbar adrenalectomy with simple postoperative care. Anatomopathological examination concluded to an adrenal tuberculoma. A posteriori, a tuberculosis work-up was performed (tuberculin test, BK test in sputum and urine) and was negative. The patient was put on an anti-tuberculosis treatment based on Isoniaside, Rifampicin, Pyrazinamide and Ethambutol for two months followed by ten months with the two major anti-tuberculosis drugs alone. The evolution was favourable