Tuberculous lumbar arachnoiditis mimicking conus cauda tumor: A case report and review of literature

Abstract

ABSTRACTTuberculous spinal arachnoiditis involving cauda equina is rare. A patient with lumbar tuberculous arachnoiditis in the absence of both vertebral and meningeal tuberculosis, which was mimicking spinal intradural extramedullary tumor is described here. Diagnosis was made based on intraoperative fi ndings and was confi rmed by histopathology. Surgical decompression along with a combination of steroid and antitubercular therapy resulted in a good outcome. At 3 months follow-up, the patient regained bladder control and was able to walk with support. Clinical features, magnetic resonance imaging, and intraoperative fi ndings are described. Pathology and the relevant literature are discussed. Based on the patient’s clinical and radiologic fi ndings, it was believed that the patient had a conus cauda tumor and was operated on. Histologic examination of the mass revealed tuberculoma. Surgical decompression followed by antituberculosis medication resulted in good outcome. Hence tuberculous arachnoiditis should be considered in diff erential diagnosis of conus cauda tumors.