Post infectious granuloma masquerading intradural extramedullary spinal tumor

Background: There are several non-neoplastic lesions which mimic intradural extramedullary spinal cord neoplasm in their radiographic and clinical presentation. Intradural extramedullary granulomas are granulomas that form within the dura mater, which is the outermost protective layer surrounding the spinal cord. Variety of infections, such as Tuberculosis or Fungal infections (histoplasmosis and coccidioidomycosis), and inflammatory conditions, such as sarcoidosis, can cause granulomas to form within the dura mater. Case description: The authors report a very rare case of intradural extramedullary non-specific inflammatory lesion of unknown origin, with no signs of infection at present. However, the patient had a history of fever and backache 3 months back for which he was treated at periphery. He has recovered from fever but backache has gradually worsened. Conclusions: Intradural extramedullary lesions that mimic a tumor can be various and difficult to interpret. Preoperative MRI does not allow a certain diagnosis because these lesions have a very similar signal intensity pattern. Specific tests for infective pathologies are useful for diagnosis, but histological examination is essential for establishing a certain diagnosis.