iMedPub Journals ht tp://journals.imedpub.com 2016 Vol. 1 No. 1:5 Case Report © Under License of Creative Commons Attribution 3.0 License | This article is available in: http://neurosurgery.imedpub.com/archive.php 1 DOI: 10.21767/2471-9633.10005 Insights in Neurosurgery ISSN 2471-9633 Pratap Chandra Nath, Manmath Kumar Dhir, Soubhagya Ranjan Tripathy and Somnath Prasad Jena Department of Neurosurgery, SCB Medical College, Cuttack, Odisha, India Corresponding author: Dr. Pratap Chandra Nath  drpratapnath@redifmail.com drpratapnathmama@gmail.com M.Ch. Trainee, Department of Neurosurgery, SCB Medical College, Cutack, Odisha, India. Tel: +91 9437782184 Citation: Nath PC, Dhir MK, Tripathy SR, et al. Intra Thoracic Extra Pulmonary Supra Apical Tuberculoma in Pot’s Disease: A Case Repor t and Review of Literatures. Neurosurg. 2016, 2:1. Introducton Spinal tuberculosis is the commonest form of skeletal tuberculosis accountng for about 50% of osteo artcular tuberculosis [1]. Spinal tuberculosis is a common infectous disease found in developing countries like India. Ofen patents present with Pot’s disease related paraplegia atended by "destructon of vertebral body, lamina, pedicle and spinous process with perivertebral abscess" Intra extra-plural supra-apical thoracic extension of spinal tuberculosis is not previously reported. We report here a case of Pot’s paraplegia and a huge intra thoracic extra-pulmonary supra apical granular tuberculoma mimicking apical tumor with its successful management. Intra Thoracic Extra Pulmonary Supra Apical Tuberculoma in Pot’s Disease: A Case Report and Review of Literatures Received: December 29 2015; Accepted: January 22, 2016; Published: January 29, 2016 Abstract Background: Spinal tuberculosis is one of the commonest forms of skeletal tuberculosis in India. It accounts for about 50% of osteo-artcular tuberculosis. Spinal tuberculosis causes signifcant morbidity in Indian Populaton. Ofen patents present with Pot’s disease related paraplegia atended by "destructon of vertebral body, lamina, pedicle and spinous process with perivertebral abscess". Huge intra-thoracic extra-pulmonary extra-plural supra- apical tuberculoma due to extension of spinal tuberculosis is not reported yet. We describe here such a case of complete paraplegia with huge chest mass and its successful management. Case descripton: A 20 years young male presented with upper thoracic Pot’s paraplegia showing involvement of D1-D3 vertebra with their lef pedicle , part of lamina , costo-vertebral and costo-transverse joint with a huge intra thoracic extra-pulmonary supra apical granular tuberculoma mimicking apical tumor. The patent was managed by a posterior “T” shaped vertcal midline approach with debridement and decompression of spinal cord and excision of intra thoracic supra apical tuberculoma extra-pleurally. He was administered ATT perioperatvely. Postoperatvely he followed up for 1 year and now able to walk, run and play normally as before. Conclusion: Pot’s spine may present with intra-thoracic extra-pleural mass which can be managed by posterior costo-transversectomy and laminectomy. So proper assessment of disease and early need full surgical interventon with ant-tubercular therapy can control severe morbidity and disability. Keywords: Spinal tuberculosis; Intra-thoracic; Extra-pulmonary; Supra-apical; Mimicking pancoast tumor Abbreviatons: D: Thoracic; C: Cervical; MRI: Magnetc Resonance Imaging; CT: Computed Tomography; FNAC: Fine Needle Aspiraton Cytology; ATT: Ant Tubercular Therapy; TB: Tuberculosis