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Open Access Highly Accessed Case report

Tuberculosis masquerading as malignancy: a multimodality approach to the correct diagnosis – a case report

Shalini Amukotuwa1*, Peter FM Choong2, Peter J Smith1, Gerard J Powell2, John Slavin3 and Stephen M Schlicht1

Author Affiliations

1 Department of Medical Imaging, St. Vincent's Hospital, Fitzroy 3065, Melbourne, Australia

2 Department of Orthopaedics, St. Vincent's Hospital, Fitzroy 3065, Melbourne, Australia

3 Department of Pathology, St. Vincent's Hospital, Fitzroy 3065, Melbourne, Australia

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International Seminars in Surgical Oncology 2005, 2:10  doi:10.1186/1477-7800-2-10

Published: 7 May 2005

Abstract

Background

Extrapulmonary tuberculosis is one of the great mimickers of medicine, and often masquerades as malignancy. As a result, patients may be referred to oncologists and surgeons for further evaluation and management, delaying the institution of appropriate anti-tuberculous drug therapy.

Case presentation

We present the case of a 21 year old man with tuberculous osteomyelitis, who was referred to the Bone and Soft Tissue Sarcoma Service at our institution with a provisional diagnosis of malignancy. Further investigation revealed extensive retroperitoneal abdominal and pelvic lymphadenopathy. The recognition of certain patterns on imaging, and finally the isolation of Mycobacterium tuberculosis from tissue samples obtained under image guidance, enabled the correct diagnosis to be made.

Conclusion

This case highlights the importance of remaining cognisant of the protean manifestations of extrapulmonary tuberculosis, and illustrates the advantage of a clinically directed multi-modality imaging approach to diagnosis.