Space-occupying lesions in Papua New Guinea--the CT era

ABSTRACT

BACKGROUND: The use of computed tomography (CT) scanning to diagnose and treat space-occupying lesions (SOL) has been a great advance. AIM: To analyze the causes, treatment and outcome of SOL. METHOD/PATIENTS An audit of all cases of SOL treated over a period of 2 years (2003-2004) after the establishment of a neurosurgical unit. RESULTS: There were 42 SOL cases affecting the intracranial space and the spine. 39 cases originated in the brain and its coverings and 3 in the spinal cord. Out of the 39 brain SOL, 26 (67%) were due to tumours and 13 (33%) were due to infection, of which tuberculosis was responsible for 6 (46%). There were 6 astrocytomas and 3 meningiomas followed by secondaries, pilocytic astrocytoma and medulloblastoma with 2 cases each. There was also one case each of pineal tumour, craniopharyngioma, pituitary adenoma, vestibular schwannoma and oligodendroglioma and 6 indeterminate cases. The 3 spinal cord SOL were due to arachnoiditis, subdural abscess and tuberculoma. CONCLUSION: Tumours were more common than tuberculosis as a cause of SOL. However, tuberculoma represented a curable condition whereas for tumours the potential for cure depended on the site, pathology and stage. CT scan was of great help in the diagnosis and localization of SOL but, unfortunately,is still not available for the majority of the Papua New Guinea population.