Intramedullary tuberculoma of thoracic spine: A rare location of an endemic disease

Abstract

Tuberculosis (TB) is endemic in India, alone contributing for two thirds of total cases worldwide. Spinal tuberculosis accounts for 1-2% of all cases of tuberculosis. However, spinal intramedullary tuberculoma occurs in as few as 2 out of 1000 cases of tuberculosis involving central nervous system. This may present in form of meningitis, tubercular spondylitis, arachnoididtis or tuberculomas mostly. The most common site of involvement is found to be the thoracic region of spine affecting relatively younger age groups and often seen in association with extraspinal tuberculosis disease. The source of intramedullary tuberculosis is mostly hematogenous spread from a site of primary TB elsewhere in the body which is usually the lungs.Due to rarity of the disease misdiagnosis is frequent.Magnetic Resonance Imaging is the investigation of choice and histopathological examination and culture are confirmatory methods for diagnosis of tuberculosis.Microsurgical resection is better option for rapidly progressing intramedullary tuberculosis cases. Here we report a rare case of isolated spinal intramedullary tuberculoma of thoracic spinal region.