Thalamic Tuberculoma Mimicking a Malignant Brain Tumor

在結核病盛行地區，顱內結核約佔顱內腫瘤的5至30個百分比，可發生在腦內之任何部位。視丘腫瘤約佔顱內腫瘤的百分之一，而視丘是顱內結核罕見之位置，文獻上僅有極少之報告。本文所呈現的案例，有經常癲癇發作的過去病史，其住院之主訴為一星期漸進性的右上肢麻木及無力。電腦斷層及核磁共振檢查高度懷疑是一左側視丘的惡性腫瘤。病人由於腦壓升高合併意識惡化而接受外科手術。病理切片證實為一顱內結核。術後二個星期的痰液培養證實有Acid-fast stain陽性反應的桿菌。患者接受多種抗結核的藥物治療後，追蹤之核磁共振顯示視丘結核已消失，病人恢復的情況良好且無進一步的惡化。儘管少見，視丘核結仍需列入顱內腫瘤的鑑別診斷。

關鍵字

腦瘤；顱內結核；視丘

並列摘要

Tuberculomas can occur at any site in the brain. In endemic areas of tuberculosis, intracranial tuberculomas account for 5% to 30% of all space-occupying brain lesions. A patient with frequent seizures presented to the neurosurgical department with a one-week history of progressive right upper limb weakness and numbness. CT scan and MRI findings revealed a malignant tumor in the left thalamus. The lesion was surgically excised because the patient's consciousness was rapidly deteriorating. Pathological examinations revealed a tuberculoma with mycobacterial infection. Sputum cultures revealed acid-fast stain positive bacilli infection two weeks after surgery despite normal chest X-ray findings. The patient took combined antituberculous drugs and recovered well without further neurological deficits during the two years of follow-up. Although rare, thalamic tuberculomas need to be considered in the differential diagnosis of intracranial lesions.

並列關鍵字

brain tumor ； intracranial tuberculoma ； thalamus

國際替代計量

Thalamic Tuberculoma Mimicking a Malignant Brain Tumor

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