Tuberculous otitis media masquerading as malignancy: a diagnostic challenge
Abstract Background Primary tuberculous otitis media is rare in the paediatric age group, and its neuro-otogenic complication of involvement of cerebellopontine angle in a child is very unusual. Tuberculosis should always be considered as a rare but possible aetiology for such neuro-otogenic lesions...
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| Format: | Article |
| Language: | English |
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SpringerOpen
2022-08-01
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| Series: | The Egyptian Journal of Radiology and Nuclear Medicine |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s43055-022-00859-0 |
| _version_ | 1828325206183116800 |
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| author | Roshan Philip Thomas Sunil Sam Varghese Vivek Agarwal Anjali B. Susan Navneet Kumar Preethi Paul |
| author_facet | Roshan Philip Thomas Sunil Sam Varghese Vivek Agarwal Anjali B. Susan Navneet Kumar Preethi Paul |
| author_sort | Roshan Philip Thomas |
| collection | DOAJ |
| description | Abstract Background Primary tuberculous otitis media is rare in the paediatric age group, and its neuro-otogenic complication of involvement of cerebellopontine angle in a child is very unusual. Tuberculosis should always be considered as a rare but possible aetiology for such neuro-otogenic lesions. Case presentation We report a case of a 13-year-old female patient who presented with left ear discharge and mass-like lesion on otoscopy. High-resolution computed tomography (HRCT) temporal bone showed erosion of petrous temporal bone, external auditory canal and ossicles. Contrast-enhanced MRI (CEMRI) revealed peripherally enhancing hetero-intense lesion epicentred in the petrous and mastoid part of left temporal bone extending into the left cerebellopontine angle and external auditory canal. Homogenously enhancing soft tissue was seen in the left occipital condyle with sigmoid sinus thrombosis and cervical lymphadenopathy. There was also a single enhancing left temporal lobe lesion. Radiological and clinical assessment was suggestive of malignant aetiology. However, biopsy revealed tuberculosis and anti-tubercular therapy (ATT) was initiated. Interval imaging showed an adequate response to treatment. Conclusions Tuberculous otitis media often masquerades as malignancy on clinical and imaging assessment. |
| first_indexed | 2024-04-13T19:19:02Z |
| format | Article |
| id | doaj.art-6012820f1f2546d592c2605f3122ec02 |
| institution | Directory Open Access Journal |
| issn | 2090-4762 |
| language | English |
| last_indexed | 2024-04-13T19:19:02Z |
| publishDate | 2022-08-01 |
| publisher | SpringerOpen |
| record_format | Article |
| series | The Egyptian Journal of Radiology and Nuclear Medicine |
| spelling | doaj.art-6012820f1f2546d592c2605f3122ec022022-12-22T02:33:36ZengSpringerOpenThe Egyptian Journal of Radiology and Nuclear Medicine2090-47622022-08-015311810.1186/s43055-022-00859-0Tuberculous otitis media masquerading as malignancy: a diagnostic challengeRoshan Philip Thomas0Sunil Sam Varghese1Vivek Agarwal2Anjali B. Susan3Navneet Kumar4Preethi Paul5Department of Radiodiagnosis, Christian Medical CollegeDepartment of ENT, Christian Medical CollegeDepartment of Neurology and Vascular Intervention, Christian Medical CollegeDepartment of Radiodiagnosis, Christian Medical CollegeDepartment of ENT, Christian Medical CollegeDepartment of Pathology, Christian Medical CollegeAbstract Background Primary tuberculous otitis media is rare in the paediatric age group, and its neuro-otogenic complication of involvement of cerebellopontine angle in a child is very unusual. Tuberculosis should always be considered as a rare but possible aetiology for such neuro-otogenic lesions. Case presentation We report a case of a 13-year-old female patient who presented with left ear discharge and mass-like lesion on otoscopy. High-resolution computed tomography (HRCT) temporal bone showed erosion of petrous temporal bone, external auditory canal and ossicles. Contrast-enhanced MRI (CEMRI) revealed peripherally enhancing hetero-intense lesion epicentred in the petrous and mastoid part of left temporal bone extending into the left cerebellopontine angle and external auditory canal. Homogenously enhancing soft tissue was seen in the left occipital condyle with sigmoid sinus thrombosis and cervical lymphadenopathy. There was also a single enhancing left temporal lobe lesion. Radiological and clinical assessment was suggestive of malignant aetiology. However, biopsy revealed tuberculosis and anti-tubercular therapy (ATT) was initiated. Interval imaging showed an adequate response to treatment. Conclusions Tuberculous otitis media often masquerades as malignancy on clinical and imaging assessment.https://doi.org/10.1186/s43055-022-00859-0Tuberculous otitis mediaTemporal bone tuberculosisPetrous temporal boneContrast-enhanced magnetic resonance imaging (CEMRI)Case report |
| spellingShingle | Roshan Philip Thomas Sunil Sam Varghese Vivek Agarwal Anjali B. Susan Navneet Kumar Preethi Paul Tuberculous otitis media masquerading as malignancy: a diagnostic challenge The Egyptian Journal of Radiology and Nuclear Medicine Tuberculous otitis media Temporal bone tuberculosis Petrous temporal bone Contrast-enhanced magnetic resonance imaging (CEMRI) Case report |
| title | Tuberculous otitis media masquerading as malignancy: a diagnostic challenge |
| title_full | Tuberculous otitis media masquerading as malignancy: a diagnostic challenge |
| title_fullStr | Tuberculous otitis media masquerading as malignancy: a diagnostic challenge |
| title_full_unstemmed | Tuberculous otitis media masquerading as malignancy: a diagnostic challenge |
| title_short | Tuberculous otitis media masquerading as malignancy: a diagnostic challenge |
| title_sort | tuberculous otitis media masquerading as malignancy a diagnostic challenge |
| topic | Tuberculous otitis media Temporal bone tuberculosis Petrous temporal bone Contrast-enhanced magnetic resonance imaging (CEMRI) Case report |
| url | https://doi.org/10.1186/s43055-022-00859-0 |
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