Intradural Extramedullary Tuberculoma of the Spinal Cord: Report of 1 Case.

Yoo, Young Mahn; Lee, Kwang Young; Lee, Sang Bong; Cho, Chong Hyo; Moon, Myung Sun

Original Article

Journal of Korean Neurosurgical Society 1982;11(1): 81-86.

Young Mahn Yoo, Kwang Young Lee, Sang Bong Lee, Chong Hyo Cho, Myung Sun Moon

Department of Neurosurgery, Seoul Red Cross Hospital, Seoul, Korea.

ABSTRACT

Tuberculoma of the spinal cord is one of rare lesions and usually produced by secondary lesion of tuberculosis. The first tuberculoma of spinal cord was described in 1830 by E.R.A. Serre and the first operative removal was performed in 1909 by Krauss and Mcguire. The most common age of tuberculoma is younger age group, especially under 30 years old and male is more frequent. The clinical symptom is rapid course and symptomatic Traid are motor, sensory, and sphincter disturbance, but early involvement is shpincter dist urbance. The authors present a case of intradural extramedullary tuberculoma of the spinal cord which was located at the thoracic region. The 63 years old female patient has complained the upper back pain and paraplegia by spontaneous onset before 3 days. On admission, paraplegia, urinary incontinence and weakness of anal sphincter were found. There were revealed within normal limit on simple flims of chest and thoracic spine. The color of the C.S.F. was xanthochromic, the amount of the protein was increased, and Quecken sted test was not patent. The contrast media was obliterated at the lower margin of 8th thoracic level and upper margin of 10th thoracic level, on myelogram by puncture of cisterna magna and lumbar region. We performed total laminectomy from T8 to T10 and removed a ID EM tuberculoma. We found white yellowish extramedullary tumor at the right postebrane. The extramedullary tumor was intermingling with dorsal nerve root on T9. The right dentate ligament and dorsal nerve root were cut and tumor was completely removed. Macroscopically the gross feature were 1.5 by 2 cm in size, white-yellowish color, hard and irregular round shape. The microscopic finding were showing multifocal granulomas with caseous necrosis. The granuloma was composed of epitheloid cells, lymphocytes and Langhans' giant cell. Post-operative recovery was very satisfactory.