Tuberculoma

A tuberculoma is a clinical manifestation of tuberculosis which conglomerates tubercles into a firm lump, and so can mimic cancer tumors of many types in medical imaging studies.[1][2] Since these are evolutions of primary complex, the tuberculomas may contain within caseum or calcifications.

Cause

With the passage of time Mycobacterium tuberculosis can transform into crystals of calcium. These can affect any organ such as the brain,[3][4] intestine,[5][6][7] ovaries,[8][9] breast,[10][11][12] lungs,[13][14] esophagus,[15] liver, pancreas,[16] bones,[17][18] and many others.

Diagnosis

Differential diagnosis

As the histologic and clinical indications, as well as tumor markers such as the CA-125, are similar, it is often difficult to differentiate tuberculoma from cancer. For these reasons, tuberculosis should always be considered in the differential diagnosis of cancer.

Treatment

Tuberculoma is commonly treated through the HRZE drug combination (Isoniazid, Rifampin, Pyrazinamide, Ethambutol) followed by maintenance therapy.[19]

References
  1. Pitlik SD, Fainstein V, Bodey GP (May 1984). "Tuberculosis mimicking cancer--a reminder". The American Journal of Medicine. 76 (5): 822–5. doi:10.1016/0002-9343(84)90993-8. PMID 6720729.
  2. Vento S, Lanzafame M (June 2011). "Tuberculosis and cancer: a complex and dangerous liaison". The Lancet. Oncology. 12 (6): 520–2. doi:10.1016/S1470-2045(11)70105-X. PMID 21624773.
  3. Dennison P, Rajakaruna G (October 2006). "Cerebral tuberculoma". Thorax. 61 (10): 922. doi:10.1136/thx.2005.054932. PMC 2104774. PMID 17008487.
  4. Chatterjee S (October 2011). "Brain tuberculomas, tubercular meningitis, and post-tubercular hydrocephalus in children". Journal of Pediatric Neurosciences. 6 (Suppl 1): S96–S100. doi:10.4103/1817-1745.85725. PMC 3208909. PMID 22069437.
  5. Herrick FC (April 1925). "Tuberculoma of the Caecum: Hyperplastic Tuberculosis". Annals of Surgery. 81 (4): 801–20. doi:10.1097/00000658-192504000-00009. PMC 1399989. PMID 17865239.
  6. Chakravartty S, Chattopadhyay G, Ray D, Choudhury CR, Mandal S (2010). "Concomitant tuberculosis and carcinoma colon: coincidence or causal nexus?". Saudi Journal of Gastroenterology. 16 (4): 292–4. doi:10.4103/1319-3767.70619. PMC 2995101. PMID 20871197.
  7. Kushwaha JK, Sonkar AA, Saraf A, Singh D, Gupta R (September 2011). "Jejunal adenocarcinoma: an elusive diagnosis". Indian Journal of Surgical Oncology. 2 (3): 197–201. doi:10.1007/s13193-011-0101-7. PMC 3272177. PMID 22942611.
  8. Elmore RG, Li AJ (December 2007). "Peritoneal tuberculosis mimicking advanced-stage epithelial ovarian cancer". Obstetrics and Gynecology. 110 (6): 1417–9. doi:10.1097/01.AOG.0000295653.32975.4a. PMID 18055741.
  9. Rabesalama S, Mandeville K, Raherison R, Rakoto-Ratsimba H (2011). "Isolated ovarian tuberculosis mimicking ovarian carcinoma: case report and literature review". African Journal of Infectious Diseases. 5 (1): 7–10. doi:10.4314/ajid.v5i1.66508. PMC 3497843. PMID 23878702.
  10. Baharoon S (July 2008). "Tuberculosis of the breast". Annals of Thoracic Medicine. 3 (3): 110–4. doi:10.4103/1817-1737.41918. PMC 2700437. PMID 19561892.
  11. Sen M, Gorpelioglu C, Bozer M (2009). "Isolated primary breast tuberculosis: report of three cases and review of the literature". Clinics. 64 (6): 607–10. doi:10.1590/S1807-59322009000600019. PMC 2705158. PMID 19578668.
  12. Akçay MN, Sağlam L, Polat P, Erdoğan F, Albayrak Y, Povoski SP (June 2007). "Mammary tuberculosis -- importance of recognition and differentiation from that of a breast malignancy: report of three cases and review of the literature". World Journal of Surgical Oncology. 5: 67. doi:10.1186/1477-7819-5-67. PMC 1910599. PMID 17577397.
  13. Liang HY, Li XL, Yu XS, Guan P, Yin ZH, He QC, Zhou BS, et al. (December 2009). "Facts and fiction of the relationship between preexisting tuberculosis and lung cancer risk: a systematic review". International Journal of Cancer. 125 (12): 2936–44. doi:10.1002/ijc.24636. PMID 19521963.
  14. Khan AN, Al-Jahdali HH, Allen CM, Irion KL, Al Ghanem S, Koteyar SS (April 2010). "The calcified lung nodule: What does it mean?". Annals of Thoracic Medicine. 5 (2): 67–79. doi:10.4103/1817-1737.62469. PMC 2883201. PMID 20582171.
  15. Patnayak R, Reddy MK, Parthasarathy S, Yootla M, Reddy V, Jena A (April 2008). "Unusual presentation of esophageal tuberculosis mimicking malignancy". Saudi Journal of Gastroenterology. 14 (2): 103–4. doi:10.4103/1319-3767.39632. PMC 2702907. PMID 19568514.
  16. Saluja SS, Ray S, Pal S, Kukeraja M, Srivastava DN, Sahni P, Chattopadhyay TK (June 2007). "Hepatobiliary and pancreatic tuberculosis: a two decade experience". BMC Surgery. 7 (1): 10. doi:10.1186/1471-2482-7-10. PMC 1925057. PMID 17588265.
  17. Herzog A (September 2009). "Dangerous errors in the diagnosis and treatment of bony tuberculosis". Deutsches Ärzteblatt International. 106 (36): 573–7. doi:10.3238/arztebl.2009.0573. PMC 2770211. PMID 19890413.
  18. Dhillon MS, Aggarwal S, Prabhakar S, Bachhal V (March 2012). "Tuberculosis of the foot: An osteolytic variety". Indian Journal of Orthopaedics. 46 (2): 206–11. doi:10.4103/0019-5413.93683. PMC 3308663. PMID 22448060.
  19. Monteiro R, Carneiro JC, Costa C, Duarte R (2013). "Cerebral tuberculomas - A clinical challenge". Respiratory Medicine Case Reports. 9: 34–7. doi:10.1016/j.rmcr.2013.04.003. PMC 3949551. PMID 26029627.


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