Presentamos el caso de una paciente de 48 años de edad, con una lesión expansiva de carácter infiltrativo a nivel fronto-parietal izquierdo y clínica focal de 5 meses de evolución. El estudio neurorradiológico evidenciaba una lesión expansiva con efecto de masa y captación irregular de contraste sugestiva de metástasis o glioma cerebral a nivel rolándico izquierdo. Se intervino quirúrgicamente consiguiéndose la resección total de la lesión. El estudio anatomopatológico objetivó la existencia de zonas de necrosis caseosa y permitió visualizar formas de BK en varios cortes. Consideramos de interés el caso, dada la escasa incidencia de tuberculomas cerebrales y la atípica forma de presentación.
We present a 48-year-old female with an infiltrative lesion in the left premotor area. She presented a progressive right side hemiparesis, particularly in the upper extremity and aphasia of 5 months’ duration.
CT and MRI showed an expansive lesion with mass effect in the left frontal area with irregular contrast enhancement, suggesting a metastasis or brain glioma.
Total removal of the lesion was achieved in surgery.
Pathological examination demonstrated a caseum and Koch bacillus (KB) and a tuberculoma was diagnosed.
Brain tuberculomas are very rare nowadays and the clinical presentation of this case was also atypical.
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