RESUMO
It was about a 61-year-old patient who presented an indurated and painless umbilical swelling surrounded by ulcerated plaque and an abdominal arch progressing for 8 months. Abdomino-pelvic ultrasound and abdominal-pelvic CT scan revealed in right ovarian the presence of a mass with a cystic's tissue, a thickness with a subcutaneous infiltration of the umbilical region and the diffuse infiltration of gastric parietal mesenteric fat. Histology of the ovarian mass confirmed Krükenberg's tumor and that of the Sister Marie-Joseph's nodule confirmed umbilical skin metastasis. The primary was a well differentiated gastric adenocarcinoma. The death occurred after the first chemotherapy treatment. The association of Krükenberg's tumor with Sister Marie-Joseph's nodule, rare and unusual, has been revealing of a gastric adenocarcinoma which up to now was unknown and asymptomatic.
RESUMO
Meningeal tuberculoma is one of the most serious sites of tuberculosis. Its incidence varies depending on the geographical area, rare in Western countries and frequent in developing countries where it represents 5% to 10% of intracranial masses. We report the case of a 21-year-old male patient with no particular medical history from Africa and living in Europe for more than a year, is hospitalized for an isolated inaugural, generalized, afebrile seizure in whom the scanner and cerebral magnetic resonance imaging (MRI) revealed a meningeal mass with significant glove finger edema suggesting a primary brain tumor. Surgical excision and anatomopathological analysis of the excisional piece allowed the diagnosis of tuberculoma. Meningeal tuberculoma is a source of diagnostic error because its clinical and radiological expression can mimic a brain tumor. This is an etiology that should not be ignored in the face of a meningeal mass in any subject coming from or living in a region with a high endemic tuberculosis.