01.12.2011 | Case report | Ausgabe 1/2011 Open Access
Testicular tuberculosis presenting with metastatic intracranial tuberculomas only: a case report
- Zeitschrift:
- Journal of Medical Case Reports > Ausgabe 1/2011
Wichtige Hinweise
Electronic supplementary material
The online version of this article (doi:10.1186/1752-1947-5-100) contains supplementary material, which is available to authorized users.
Competing interests
The authors declare that they have no competing interests.
Authors' contributions
GIO and OSB analyzed and interpreted the patient data regarding testicular disease and surgical findings. CAO performed the histological examination of the testicular specimen and was a major contributor in writing the manuscript. GIO and OSB reviewed the literature and wrote the first draft of the manuscript. AOO and GIO reviewed the manuscript for important intellectual content. SOU performed the sonography, provided images and made contributions to the draft. All authors read and approved the final manuscript.
Abstract
Introduction
Intracranial tuberculomas are a rare complication of tuberculosis occurring through hematogenous spread from an extracranial source, most often of pulmonary origin. Testicular tuberculosis with only intracranial spread is an even rarer finding and to the best of our knowledge, has not been reported in the literature. Clinical suspicion or recognition and prompt diagnosis are important because early treatment can prevent patient deterioration and lead to clinical improvement.
Case presentation
We present the case of a 51-year-old African man with testicular tuberculosis and multiple intracranial tuberculomas who was initially managed for testicular cancer with intracranial metastasis. He had undergone left radical orchidectomy, but subsequently developed hemiparesis and lost consciousness. Following histopathological confirmation of the postoperative sample as chronic granulomatous infection due to tuberculosis, he sustained significant clinical improvement with antituberculous therapy, recovered fully and was discharged at two weeks post-treatment.
Conclusion
The clinical presentation of intracranial tuberculomas from an extracranial source is protean, and delayed diagnosis could have devastating consequences. The need to have a high index of suspicion is important, since neuroimaging features may not be pathognomonic.