Cubital Tunnel Syndrome caused by an Ulnar Nerve Tuberculoma: A rare case report and Literature Review

Document Type : Case reports.

Authors

1 Consultant, Department of Orthopedic Surgery, Qena General Hospital, Qena, Egypt.

2 Specialist, Department of Orthopedic Surgery, Qena General Hospital, Qena, Egypt.

Abstract

Background: Tuberculosis has a very weak affinity of peripheral nerves, and the presence of a tuberculoma within a peripheral nerve is only detected sporadically.
Case Report: A 64-year-old male patient presented to Qena General Hospital Orthopaedic Department in February 2022 with symptoms and signs suggestive of cubital tunnel syndrome. During the operation, a fusiform swelling containing a caseous material was noticed within the ulnar nerve. The lesion was found to be an ulnar nerve tuberculoma. The patient showed partial neurologic recovery after surgery followed by an incomplete course of anti-tuberculous medication.
Conclusion: Although extremely rare, tuberculous affection of the ulnar nerve can occur. The previously reported cases involved the nerve either proximal or distal to the cubital tunnel, unlike our case which presented with a tuberculoma within the tunnel. Thus, in addition to the usual clinical and electrophysiological assessment, it is advisable to perform ultrasound evaluation in all cases of cubital tunnel syndrome; first to assess the nerve for subluxation, and second to exclude any intra- or extra-neural lesion that may be the cause of entrapment.

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