Primary intramedullary tuberculoma: a rare manifestation of a common disease: case report and literature review

Abstract Intramedullary tuberculoma is an exceptional cause of spinal cord compression, most often occurring in specific clinical settings. Although rare, it is a serious condition due to its potential to cause significant and sometimes irreversible neurological damage, requiring prompt diagnosis and appropriate treatment. Early surgical intervention allows for spinal cord decompression, confirms the diagnosis, and enables timely initiation of antituberculous therapy. We report the case of a 33-year-old woman diagnosed histologically with an intramedullary tuberculoma, in the absence of systemic tuberculosis symptoms. The lesion, located in the thoracic spine, radiologically mimicked an intramedullary tumor. The patient underwent a D10–D12 laminectomy with biopsy. Histological analysis confirmed the diagnosis of intramedullary tuberculoma. Antituberculous therapy was started immediately. Neurological signs and symptoms gradually improved postoperatively. Although rare, intramedullary tuberculoma should be considered among the differential diagnoses for spinal cord compression, even in patients without clinical signs of tuberculosis.