PMC5379806_01
(a) Pre-operative plain axial computed tomography (CT) scan demonstrating isodense lesion in the anterior third ventricle with obstructive hydrocephalus. (b) Post VP shunt CT scan of the brain of the same patient
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F1
Plain CT scan of the brain revealed third ventricular mass with obstructive hydrocephalus [Figure 1a]. Post-operative CT scan of the brain showed decreased sizes of the ventricles [Figure 1b].
(a) Pre-operative magnetic resonance imaging (MRI) with sagittal cut after contrast showing well-enhanced third ventricular mass. (b) Post-operative MRI with contrast revealed on residual mass
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F2
T1W and hypointense on T2W images. The lesion was homogenously enhanced after intravenous gadolinium injection [Figure 2a and b]. Before discharge, MRI of the brain with intravenous contrast was ordered, and it showed no evidence of residual lesion, and Foramen of Monro was opened up [Figure 2c].
Surgical specimen, the mass was round, has smooth surface and firm in consistency, gray- white appearance upon sectioning
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F3
The tumor was smooth and round, firm in consistency, moderately vascular and attached to the Foramen of Monro [Figure 3].
Photomicrograph (H and E, x160) showing Langhans giant cells and epitheloid cells that are characteristic features of tuberculoma
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F4
Surprisingly, histological examination revealed granulomatous lesion with epitheloid and Langhans cells, consistent with tuberculoma [Figure 4].