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Abstract

Tuberculosis continues to plague the developing parts of the world. In spite of implementing multiple Tuberculosis control programs, Tuberculosis persists as a leading public health menace in India. Central Nervous System (CNS) Tuberculosis predominantly manifests as meningitis, tuberculomas and brain abscesses. Giant tuberculoma, classified as a large neoplastic mass is a rare entity, accounting for <2 % of all CNS tuberculosis cases. Majority of the tuberculomas in the pediatric population are reported in the infratentorial region therefore a frontal lobe presentation is extremely rare. Patients with tuberculoma often present with features mimicking neoplasm lasting months to years. Based on imaging studies, such cases are often misdiagnosed as neoplasms; however, when an imaging study is combined with MSR spectroscopy reading, an accurate diagnosis can be made. We herein report a rare presentation of Frontal lobe Giant Tuberculoma in an adolescent Indian female who suffered from headache, deviation of face to the right, diplopia of left lateral gaze and loss of sensation in upper part of face with 7th nerve upper motor neuron type palsy. On fundus examination, bilateral papilloedema was present. MRI Brain revealed a ring enhancing lesion (>2.5cm) of deep frontal lobe with a 9.5mm midline shift and effacement of lateral ventricle. On MR spectroscopy, lipid laden peaks which was suggestive of Tuberculoma. Treatment was started with anti tubercular medications with steroids and anti edema measures. Patient is in Recovery with symptomatic resolution of headache, diplopia and paresthesia. Post initiation phase MRI shows a decrease in lesion size and complete resolution of peripheral edema.

Biography

Neetipriya Pandey is a Third Year Pediatric Resident at Farooq Hussain Medical College in Agra, Uttar Pradesh India. The hospital serves the residents of District Firozabad and surrounding rural regions. Dr. Neetipriya Pandey is passionate about health care initiatives at the grassroot level and looks forward to further study public health policy to improve outcomes amongst underprivileged pediatric populations.