Isolated Cerebellar Spindle Cell Pseudotumor Caused by Mycobacterium Avium-Intracellulare Complex in a Patient without AIDS

World Neurosurg. 2016 Jun:90:703.e1-703.e3. doi: 10.1016/j.wneu.2016.02.082. Epub 2016 Feb 27.

Abstract

Background: Spindle cell pseudotumors are formed by histiocytes in response to infection by Mycobacterium avium-intracellulare complex (MAC) and are rare in patients without AIDS.

Case description: A 66-year-old man presented with neck pain, ataxia, and a history of sarcoidosis. A cerebellar lesion was identified on magnetic resonance imaging and surgically excised. Histopathology revealed this to be a spindle cell pseudotumor and MAC was isolated by bacterial culture of cerebrospinal fluid. Hematology revealed cluster of differentiation 4 lymphocytopenia but human immunodeficiency virus serology was negative. The patient was commenced on antimicrobial treatment that included a macrolide and remained well at 1 year follow-up.

Conclusions: This rare presentation of isolated intracranial MAC was treated with surgical excision and antimicrobials with a good outcome.

Keywords: Cerebellum; Intracranial; Mycobacterium avium complex; T-lymphocytopenia idiopathic CD4-positive.

Publication types

  • Case Reports

MeSH terms

  • Acquired Immunodeficiency Syndrome
  • Aged
  • Anti-Bacterial Agents / administration & dosage
  • Cerebellar Diseases / pathology*
  • Cerebellar Diseases / therapy*
  • Combined Modality Therapy / methods
  • Diagnosis, Differential
  • Humans
  • Male
  • Mycobacterium avium-intracellulare Infection / pathology*
  • Mycobacterium avium-intracellulare Infection / therapy*
  • Neurosurgical Procedures / methods
  • Treatment Outcome

Substances

  • Anti-Bacterial Agents