An 83-year-old man presented with multiple ring-enhancing nodular lesions on contrast-enhanced magnetic resonance imaging (MRI) of the brain. A metastatic brain tumor was initially suspected, but a systematic examination, revealed no primary lesion. A surgical biopsy demonstrated pathological features consistent with tuberculosis, and the patient was transferred to our hospital.

Although mycobacterium tuberculosis was not detected in various culture tests, the pathological findings supported a clinical diagnosis of intracranial tuberculoma, and appropriate treatment was initiated. Intracranial tuberculoma without associated meningitis is extremely rare, which can lead to delayed diagnosis and treatment initiation and, in turn, to unfavorable outcomes. Therefore, this condition should be considered in the differential diagnosis of intracranial nodular lesions with ring enhancement on head MRI. In our case, treatment was given promptly and successfully, leading to a favorable prognosis.