{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,8,28]],"date-time":"2025-08-28T09:10:29Z","timestamp":1756372229396,"version":"3.44.0"},"reference-count":5,"publisher":"BMJ","issue":"4","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Rep"],"accepted":{"date-parts":[[2022,4,5]]},"published-print":{"date-parts":[[2022,4]]},"abstract":"<jats:p>We present an 11-year-old girl who manifested with unprovoked right-sided focal motor seizures. CT revealed a large lobulated hypodense mass in the left temporoparietal lobe, with perilesional oedema and postcontrast peripheral enhancement. Diagnostic uncertainty resulted in further neuroimaging, which included MRI with modalities including diffusion-weighted imaging, perfusion imaging, as well as spectroscopy. We discuss the radiological features of the lesion, which steered us in the direction of an infective cause. Definitive diagnosis was achieved by brain needle biopsy, which demonstrated necrotising granulomatous inflammation indicative of tuberculous infection on histology. In addition, GeneXpert yielded a positive result. We believe this unique case highlights the diagnostic dilemma clinicians face in differentiating ring-enhancing lesions on neuroimaging in tuberculosis-endemic regions. It also highlights the potential benefit of a brain needle biopsy (histology and GeneXpert) in cases of uncertainty.<\/jats:p>","DOI":"10.1136\/bcr-2021-248545","type":"journal-article","created":{"date-parts":[[2022,5,23]],"date-time":"2022-05-23T11:20:33Z","timestamp":1653304833000},"page":"e248545","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":2,"title":["Giant cerebral tuberculoma mimicking a high-grade tumour in a child"],"prefix":"10.1136","volume":"15","author":[{"given":"Magriet","family":"Van Niekerk","sequence":"first","affiliation":[{"name":"Paediatrics and Child Health, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1146-1307","authenticated-orcid":false,"given":"Pierre","family":"Goussard","sequence":"additional","affiliation":[{"name":"Paediatrics and Child Health, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ronald","family":"Van Toorn","sequence":"additional","affiliation":[{"name":"Paediatrics and Child Health, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5607-8443","authenticated-orcid":false,"given":"Regan","family":"Solomons","sequence":"additional","affiliation":[{"name":"Paediatrics and Child Health, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2022,4,20]]},"reference":[{"key":"2025082801330747000_15.4.e248545.1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejrad.2012.06.005"},{"key":"2025082801330747000_15.4.e248545.2","doi-asserted-by":"crossref","first-page":"214","DOI":"10.1097\/INF.0000000000000539","article-title":"Clinicoradiologic response of neurologic tuberculous mass lesions in children treated with thalidomide","volume":"34","author":"van Toorn","year":"2015","journal-title":"Pediatr Infect Dis J"},{"key":"2025082801330747000_15.4.e248545.3","doi-asserted-by":"publisher","DOI":"10.1258\/ar.2012.120347"},{"key":"2025082801330747000_15.4.e248545.4","doi-asserted-by":"crossref","first-page":"102016","DOI":"10.1016\/j.tube.2020.102016","article-title":"The immunological architecture of granulomatous inflammation in central nervous system tuberculosis","volume":"125","author":"Zaharie","year":"2020","journal-title":"Tuberculosis"},{"key":"2025082801330747000_15.4.e248545.5","doi-asserted-by":"publisher","DOI":"10.1128\/JCM.03553-13"}],"container-title":["BMJ Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bcr-2021-248545","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,8,28]],"date-time":"2025-08-28T08:33:12Z","timestamp":1756369992000},"score":1,"resource":{"primary":{"URL":"https:\/\/casereports.bmj.com\/lookup\/doi\/10.1136\/bcr-2021-248545"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,4]]},"references-count":5,"journal-issue":{"issue":"4","published-online":{"date-parts":[[2022,4,20]]},"published-print":{"date-parts":[[2022,4]]}},"alternative-id":["10.1136\/bcr-2021-248545"],"URL":"https:\/\/doi.org\/10.1136\/bcr-2021-248545","relation":{},"ISSN":["1757-790X"],"issn-type":[{"type":"electronic","value":"1757-790X"}],"subject":[],"published":{"date-parts":[[2022,4]]}}}