Oshika H, Abe T, Hattori N, Maeda H, Ogasawara T, Suzuki M, Totani Y, Senda Y
Department of Respiratory Disease, Nagoya Daini Red Cross Hospital, Japan.
Kekkaku. 1995 Aug;70(8):477-81.
A 47-year old woman was admitted to our hospital with complaints of headache and right occipital swelling. Brain CT scan showed right occipital bone defect with a sequestrum and soft tissue swelling. T1 weighted MRI enhanced by GD-DTPA revealed several nodules. A right occipital craniotomy was performed. Subcutaneous pus and a well-circumscribed yellowish, firm mass which existed under the bone defect was extirpated. Pathologically, this mass was considered to be a tuberculoma and intracranial nodules were suspected to be cerebral tuberculosis. Anti-tuberculous therapy was started. Since her admission fecal occult blood continued and endoscopic examination with biopsy revealed sigmoid colon cancer. Sigmoidectomy was performed and she has been well during 1 year post-operative follow up. Although tuberculous disease are decreasing in number in our country, we must take into account of the existence of skull tuberculosis.
一名47岁女性因头痛和右枕部肿胀入院。脑部CT扫描显示右枕骨缺损伴死骨及软组织肿胀。经钆喷酸葡胺（GD-DTPA）增强的T1加权磁共振成像（MRI）显示有多个结节。行右枕部开颅手术。切除了皮下脓液及骨缺损下方一个边界清楚的淡黄色实性肿块。病理检查认为该肿块为结核瘤，怀疑颅内结节为脑结核。开始抗结核治疗。自入院以来，粪便潜血持续存在，内镜检查及活检显示为乙状结肠癌。行乙状结肠切除术，术后1年随访期间情况良好。尽管我国结核病数量在减少，但我们仍必须考虑颅骨结核的存在。
