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Peer-reviewedCC BY-NC 4.0Iranian Journal of Child Neurology

Intramedullary Spinal Tuberculosis Mimicking Neoplasm with Ocular Involvement in an Adolescent: A Case Report

  • Tommy Alfandy Nazwar1
  • Nasim Amar2
  • Shelby Amrus Ernanda3
  • Farhad Bal’afif1
  • Donny Wisnu Wardhana1
  • Fachriy Bal’afif1
  • Christin Panjaitan1
  • Indri Febriani1
  1. 1Division of Neurosurgery, Department of Surgery, Faculty of Medicine, Brawijaya University - Dr. Saiful Anwar General Hospital, Malang, East Java, Indonesia
  2. 2Faculty of Medicine, Brawijaya University - Dr. Saiful Anwar General Hospital, Malang, East Java, Indonesia
  3. 3Neurology Study Program, Faculty of Medicine, Brawijaya University – Dr. Saiful Anwar General Hospital, Malang, East Java, Indonesia
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Abstract

Tuberculosis (TB) continues to represent one of the key health problems of high-burden nations. The childhood population is particularly vulnerable to extrapulmonary TB. Spinal intramedullary TB is extremely uncommon and can imitate neoplastic conditions, leading to a late diagnosis with fatal outcome. The current research intends to present a complex case of multisystem TB with intramedullary spinal infection that was incorrectly diagnosed and treated as a neoplasm in a pediatric patient and demonstrate the negative consequences of such misinterpretation. The authors report on a 16-year-old patient who had a low socioeconomic status and suffered from progressive bilateral lower-extremity paresis, vision problems, and multisystemic involvement. MRI demonstrated an intramedullary mass at T5–T6 with syringomyelia, para-aortic lymphadenopathy, and hepatosplenomegaly, initially suspected to be a spinal tumor. During hospitalization, he developed hydrocephalus, seizures, and respiratory failure. He underwent ventriculoperitoneal shunting and excision of the spinal lesion. Histopathology confirmed intramedullary spinal TB. Despite maximal supportive management, he deteriorated and ultimately progressed to brainstem death due to multisystem complications. This case emphasizes the need to consider TB in the differential diagnosis of spinal cord masses in children from endemic regions, particularly when ocular or systemic involvement is present. Early recognition and prompt initiation of anti-TB therapy are essential to prevent irreversible morbidity and mortality.

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Cite

BibTeXRIS
BibTeX
@article{nazwar2026intramedullary,
  title = {{Intramedullary Spinal Tuberculosis Mimicking Neoplasm with Ocular Involvement in an Adolescent: A Case Report}},
  author = {Tommy Alfandy Nazwar and Nasim Amar and Shelby Amrus Ernanda and Farhad Bal’afif and Donny Wisnu Wardhana and Fachriy Bal’afif and Christin Panjaitan and Indri Febriani},
  journal = {Iranian Journal of Child Neurology},
  year = {2026},
  month = sep,
  doi = {10.22037/ijcn.v20i4.50437},
  url = {https://doi.org/10.22037/ijcn.v20i4.50437},
  note = {CC BY-NC 4.0},
}
RIS
TY  - JOUR
TI  - Intramedullary Spinal Tuberculosis Mimicking Neoplasm with Ocular Involvement in an Adolescent: A Case Report
AU  - Tommy Alfandy Nazwar
AU  - Nasim Amar
AU  - Shelby Amrus Ernanda
AU  - Farhad Bal’afif
AU  - Donny Wisnu Wardhana
AU  - Fachriy Bal’afif
AU  - Christin Panjaitan
AU  - Indri Febriani
PY  - 2026
DA  - 2026/09/01
JO  - Iranian Journal of Child Neurology
DO  - 10.22037/ijcn.v20i4.50437
UR  - https://doi.org/10.22037/ijcn.v20i4.50437
AB  - Tuberculosis (TB) continues to represent one of the key health problems of high-burden nations. The childhood population is particularly vulnerable to extrapulmonary TB. Spinal intramedullary TB is extremely uncommon and can imitate neoplastic conditions, leading to a late diagnosis with fatal outcome. The current research intends to present a complex case of multisystem TB with intramedullary spinal infection that was incorrectly diagnosed and treated as a neoplasm in a pediatric patient and demonstrate the negative consequences of such misinterpretation. The authors report on a 16-year-old patient who had a low socioeconomic status and suffered from progressive bilateral lower-extremity paresis, vision problems, and multisystemic involvement. MRI demonstrated an intramedullary mass at T5–T6 with syringomyelia, para-aortic lymphadenopathy, and hepatosplenomegaly, initially suspected to be a spinal tumor. During hospitalization, he developed hydrocephalus, seizures, and respiratory failure. He underwent ventriculoperitoneal shunting and excision of the spinal lesion. Histopathology confirmed intramedullary spinal TB. Despite maximal supportive management, he deteriorated and ultimately progressed to brainstem death due to multisystem complications. This case emphasizes the need to consider TB in the differential diagnosis of spinal cord masses in children from endemic regions, particularly when ocular or systemic involvement is present. Early recognition and prompt initiation of anti-TB therapy are essential to prevent irreversible morbidity and mortality.
SN  - 1735-4668
SN  - 2008-0700
ER  -