Continued diagnostic challenges of central nervous system tuberculoma in the 21st century. A clinicoradiological and pathological case series

Background: A broad spectrum of non-neoplastic conditions can radiologically and clinically present as an intracranial tumour. The causes may include infectious diseases such as tuberculosis and non-infectious which may range from benign to malignant tumours. In these cases, a histological diagnosis is crucial since it determines the specific course of treatment the patient needs. Methods: A retrospective study of cerebral tuberculoma diagnosed between 2012 and 2022. The laboratory information system and patient records were used to retrieve the clinico-radiological, pathological, and therapeutic characteristics. Results: A total of 10 cases cerebral tuberculoma were diagnosed which consisted of men exclusively with mean age of 34.4 years. Human immunodeficiency virus was noted in 70% of the cases, all of which were on antiretroviral therapy. Seizures were the most common symptoms followed by headache. The radiological differential diagnosis ranged from infectious to malignant processes. All the patients underwent successful neurosurgical intervention and received anti-tuberculous treatment with good clinical outcomes. Conclusion: Cerebral tuberculoma and neoplastic diseases can share clinical and radiological characteristics. In HIV prevalent region, it is crucial to have a high index of suspicion for cerebral tuberculoma. The ability to distinguish between this infection and a neoplastic process by histopathology allows for early and precise therapy, which reduces morbidity and death.