J Korean Foot Ankle Soc.  2019 Jun;23(2):71-73. 10.14193/jkfas.2019.23.2.71.

Sural Nerve Tuberculoma: A Case Report

• Lee JM
• Suh JS
• Kim HS
• Choi JY

• KMID: 2449675
• DOI: http://doi.org/10.14193/jkfas.2019.23.2.71

Abstract

Nearly one third of the world's population have active or latent tuberculosis, resulting in 1.5 million deaths annually. Tuberculosis involving the peripheral nerve is difficult to detect. Sural nerve tuberculoma is an extremely rare case of tuberculous involvement of the peripheral nerve that has attracted the attention of physicians. This paper reports a patient with sural nerve tuberculoma. A 58-year-old female patient presented with a palpable mass on the posterolateral calf with progressive tingling sensation on the distal area. The patient had no history of trauma and it was unclear whether the patient had any contact with individuals with active tuberculosis. The histopathologic findings revealed a granuloma-like lesion with caseous necrosis that was compatible with tuberculoma.

Keyword

Tuberculoma; Sural nerve; Peripheral nerve granuloma

MeSH Terms

Female
Humans
Latent Tuberculosis
Middle Aged
Necrosis
Peripheral Nerves
Sensation
Sural Nerve*
Tuberculoma*
Tuberculosis

Figure

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  Figure 1 A 2×4 cm2 sized, fixed, tender mass on the posterolateral aspect of right calf was noted.

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  Figure 2 Fusiform dilatation of the sural nerve was seen. Low signal intensity on T1-weighted sagittal (arrow; A) and axial (B) images and intermediate to high signal intensity on T2-weighted sagittal (arrow; C) and axial (D) images were shown on magnetic resonance imaging.

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  Figure 3 (A) During the operation, an enlarged and hardened sural nerve was note. (B) Since the proximal and distal borders of the mass were not clearly distinguished, the mass was removed sufficiently include the normal nerve fiber (1.0×7.5×0.5 cm3). P: proximal, D: distal.

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  Figure 4 (A) On histopathological examination, granulomatous inflammation which peripheral inflammation cells (i.e., macrophages and epithelioid cells) surrounded the caseous necrosis was seen (H&E stain, ×40). (B) Horseshoe-shaped Langhans giant was also detected among granulomas (H&E stain, ×200).

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