Dados do Trabalho

Título

Meningoepithelial Meningioma Associated With Tuberculosis: A Case Report

RESUMO

Case Presentation: A 79-year-old woman admitted to the hospital with a history of seizures and difficulty speaking. She reports thirteen years of infrequent headaches, no seizures or auditory symptoms and a lesion suggestive of meningioma confirmed via computed tomography, also reporting having been oligonsymptomatic for 11 years with only mild leukopenia. Three years ago she presented frontal alopecia and after a new CT scan of the skull without contrast that showed an oval lesion, isoattenuated in relation to the cerebral cortex with a regular contour, measuring 2x1.5 cm in diameter, of extra-axial left frontal parrasagittal location in direct contact with the isolateral superior frontal gyrus without perilesional edema. In January 2020 he had a seizure with loss of voice for about five minutes and two months later he developed a second seizure with the same clinical manifestation. Magnetic resonance imaging showed an oval lesion located in the left frontal parasagittal region with a diameter of 2.5x2.0x2.0 cm and significant perilesional edema. After 6 months, in July of the same year, the patient presented six crises during a period of four days, and the surgical treatment of tumor excision was indicated.
Discussion: Intracranial tuberculosis has several forms, including tuberculoma and tuberculous abscesses, which often mimic a meningioma radiologically, requiring histopathological and immunohistochemical examination to confirm the diagnosis. The present paper reports a case of coexistence between a meningoendothelial meningioma associated with multiple epithelioid granulomas with foci of caseous necrosis, possibly being the first case reported in anatomopathological images with immunohistochemistry of this association of a tumor with colonization by Koch's bacillus.
Final Considerations: This case study reported a meningothelial meningioma associated with multiple epithelioid granulomas with foci of caseous necrosis, thus being one of the first cases with this rare association and that in the anatomopathological examination with immunohistochemistry shows the presence of Koch's bacillus.

Palavras Chave

Intracranial tuberculosis. Meningoepithelial meningioma. Immunohistochemistry. Histopathological.