Extrapulmonary tuberculosis presenting as diplopia: a case report of an atypically located tuberculoma in an immunocompetent patient in a non-endemic region

BACKGROUND: Central nervous system tuberculosis occurs due to blood spread, with meningitis being more common than tuberculomas. In non-endemic areas, tuberculomas are more frequent in immunocompromised patients. CASE PRESENTATION: Our case report presents a young girl who presented to the University and Polytechnic Hospital La Fe, Valencia, Spain. After examination, she was diagnosed with a cerebellar tuberculoma, despite having no other risk factors besides her mother having tuberculosis during her pregnancy. Medical treatment alone, without surgery, was sufficient to treat her condition. CONCLUSION: Diagnosing tuberculomas can be challenging in non-endemic regions and patients without high-risk factors, particularly since these lesions can present as the initial manifestation of tuberculosis without fever or leukocytosis. Surgical intervention is generally not required for their diagnosis, management, or treatment.