Intracranial Tuberculoma Mimicking Malignant Tumor in a Hemodialysis-Dependent Patient With Multimorbidity: Diagnostic Challenges and Molecular Pathologic Confirmation.

Abstract

Central nervous system tuberculomas are clinically rare (accounting for 1%-2% of intracranial space-occupying lesions), and they are particularly prone to misdiagnosis as malignant tumors when there is a lack of symptoms of tuberculosis intoxication. This article reports a case of a 39-year-old female who presented with generalized tonic-clonic seizures. Imaging suggested a malignant invasive lesion in the frontal lobe with skull base destruction. The patient had multiple high-risk factors including hemodialysis, diabetes, and anticoagulation after coronary stent placement, and was ultimately diagnosed with intracranial tuberculoma through molecular pathology. This case highlights the insidious nature of extrapulmonary tuberculosis and the diagnostic challenges under the coexistence of multiple diseases, providing a reference for diagnosis in similar complex cases.