第21巻 2025年12月　第4号

■症例報告

悪性腫瘍と鑑別を要した頭蓋内結核腫の1例
小澤　頌¹, 寺師　直樹¹, 尾関　友博², 羽鳥　努³, 清家　正博⁴, 岡野　哲也^1
1日本医科大学千葉北総病院呼吸器内科
²日本医科大学千葉北総病院脳神経外科
³日本医科大学千葉北総病院病理診断科
⁴日本医科大学大学院医学研究科呼吸器内科学分野

Intracranial Tuberculoma Mimicking Malignant Tumor: A Case Report
Sho Ozawa¹, Naoki Terashi¹, Tomohiro Ozeki², Tsutomu Hatori³, Masahiro Seike⁴ and Tetsuya Okano^1
1)Department of Respiratory Medicine, Nippon Medical School Chiba Hokusoh Hospital
²⁾Department of Neurosurgery, Nippon Medical School Chiba Hokusoh Hospital
³⁾Department of Pathology, Nippon Medical School Chiba Hokusoh Hospital
⁴⁾Department of Respiratory Medicine and Oncology, Graduate School of Medicine, Nippon Medical School

An 83-year-old man presented with multiple ring-enhancing nodular lesions on contrast-enhanced magnetic resonance imaging (MRI) of the brain. A metastatic brain tumor was initially suspected, but a systematic examination, revealed no primary lesion. A surgical biopsy demonstrated pathological features consistent with tuberculosis, and the patient was transferred to our hospital.
Although mycobacterium tuberculosis was not detected in various culture tests, the pathological findings supported a clinical diagnosis of intracranial tuberculoma, and appropriate treatment was initiated. Intracranial tuberculoma without associated meningitis is extremely rare, which can lead to delayed diagnosis and treatment initiation and, in turn, to unfavorable outcomes. Therefore, this condition should be considered in the differential diagnosis of intracranial nodular lesions with ring enhancement on head MRI. In our case, treatment was given promptly and successfully, leading to a favorable prognosis.

日医大医会誌 2025; 21(4), 342-346

Key words
intracranial tuberculoma, ring enhancement, paradoxical reaction

Correspondence to
Sho Ozawa, Department of Respiratory Medicine, Nippon Medical School Chiba Hokusoh Hospital, 1715 Kamagari, Inzai, Chiba 270-1694
E-mail：s16-022os@nms.ac.jp

受付：2025年8月7日　受理：2025年9月26日