Journal of Korean Neurosurgical Society

The Korean Neurosurgical Society (대한신경외과학회)
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Atypical Presentation of Spinal Tuberculosis Misadiagnosed as Metastatic Spine Tumor

  • Kim, Dong-Woo (Department of Neurosurgery, College of Medicine, Dong-A University) ;
  • Choi, Hyu-Jin (Department of Neurosurgery, College of Medicine, Dong-A University) ;
  • Kim, Hyung-Dong (Department of Neurosurgery, College of Medicine, Dong-A University) ;
  • Song, Young-Jin (Department of Neurosurgery, College of Medicine, Dong-A University)
  • Published : 2006.06.30
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Abstract

We present a case of a 68-year-old female with an atypical form of spinal tuberculosis, which involved posterior elements with multiple foci in two noncontiguous vertebral levels. The lesions caused spastic paraparesis and urinary hesitation. There was no evidence of pulmonary or other extrapulmonary tuberculous disease. Based on clinical and radiographic findings, this atypical spinal tuberculosis was preoperatively misdiagnosed as metastatic spine tumor. The histopathologic finding confirmed tuberculosis and the patient was treated successfully with surgery and antituberculous therapy. In case of a spinal lesion of unknown origin, it is important to be aware that atypical spinal tuberculosis can mimic metastatic spine tumor and tuberculosis should always be considered.

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References

  1. Batson OV : The function of the vertebral veins and their role in the spread of metastases. Ann Surg 112 : 138-149, 1940 https://doi.org/10.1097/00000658-194007000-00016
  2. Bell D, Cockshott WP : Tuberculosis of the vertebral pedicles. Radiology 99 : 43-48, 1971 https://doi.org/10.1148/99.1.43
  3. Dolin PJ, Raviglione MC, Kochi A : Global tuberculosis incidence and mortality during 1990-2000. Bull World Health Org 72 : 213-220, 1994
  4. Erol Y, Gokhan P, Seref A : Atypical tuberculosis of the Spine. Yonsei Med J 41 : 657-661, 2000 https://doi.org/10.3349/ymj.2000.41.5.657
  5. Esses SI : Infections of the spine. In : Esses SI, ed. Textbook of spinal disorders. Philadelphia : JB Lippincott, 1995, pp229-241
  6. Hodgson AR : Tuberculosis of the spine. In : Rothman RH, Simeone FA, eds. The spine. Philadelphia : WB Saunders Co., 1975, pp573-595
  7. Jang JS, Lee SH : Atypical form of multiple spinal tuberculosis. J Korean Neurosurg Soc 36 : 340-341, 2004
  8. Kapoor SK, Garg V, Dhaon BK, Jindal M : Tuberculosis of the posterior vertebral elements : a rare cause of compression of the cauda equina. A case report. J Bone Joint Surg 87A : 391-394, 2005
  9. Kumar K : A clinical study and classification of posterior spinal tuberculosis. Int Orthop 9 : 147-152, 1985 https://doi.org/10.1007/BF00268164
  10. Maher D, Harries AD : Tuberculosis series : organization of an effective national tuberculosis control programme. Postgrad Doc Middle East 19 : 292-296, 1996
  11. McKee DF, Barr WM, Bryan CS, Lunceford EM Jr : Primary aspergillosis of the spine mimicking Pott's paraplegia. J Bone Joint Surg 66 : 1481-1483, 1984 https://doi.org/10.2106/00004623-198466090-00030
  12. Naim-Ur-Rahman : Atypical forms of spinal tuberculosis. J Bone Joint Surg 62B : 162-165, 1980
  13. Naim-Ur-Rahman, Al-Arabi KM, Khan FA : Atypical forms of spinal tuberculosis. Acta Neurochir 88 : 26-33, 1987 https://doi.org/10.1007/BF01400511
  14. Naim-Ur-Rahman, El-Bakry A, Jamjoom A, Jamjoom ZA, Kolawole TM : Atypical forms of spinal tuberculosis : case report and review of the literature. Surg Neurol 51 : 602-607, 1999 https://doi.org/10.1016/S0090-3019(98)00101-3
  15. Naim-Ur-Rahman, Jamjoom AB, Jamjoom ZAB, Al-Tahan AM : Neural arch tuberculosis : radiological features and their correlation with surgical findings. Br J Neurosurg 11 : 32-38, 1997 https://doi.org/10.1080/02688699746663
  16. Obisesan AA, Lagundoye SB, Lawson EA : Radiological features of tuberculosis of the spine in Ibadan, Nigeria. Afr J Med Sci 6 : 55-67, 1977
  17. Ragland RL, Abdelwahab IF, Braffman B, Moss DS : Posterior spinal tuberculosis : A case report. Am J Neuroradiol 11 : 612-613, 1990
  18. Sharif HS, Aideyan OA, Clark DC, Madkour MM, Aabed MY, Mattsson TA, et al : Brucellar and tuberculous spondylitis : comparative imaging features. Radiology 171 : 419-425, 1989 https://doi.org/10.1148/radiology.171.2.2704806
  19. Tuli SM : Tuberculosis of the spine. In Tuli SM, editor. Tuberculosis of the skeletal system. 2nd ed. New Delhi : Jaypee Brothers Medical, 1997, pp 177-311
  20. Tuli SM, Srivastava TP, Varma BP, Sinha GP : Tuberculosis of the spine. Acta Orthop Scand 38 : 445-458, 1967 https://doi.org/10.3109/17453676708989653
  21. Weaver P, Lifeso RM : The radiological diagnosis of tuberculosis of the adult spine. Skeletal Radiol 12 : 178-186, 1984 https://doi.org/10.1007/BF00361084