Volume 6, 2020
|Number of page(s)||5|
|Published online||28 May 2020|
Tuberculosis (T.B.) masquerading as tumor. An 8-year study on 25 cases of long bone tuberculosis presenting as tumors
Department of Orthopedics, P D Hinduja Hospital and Medical Research Centre, Mahim, Mumbai 400016, India
2 Dr Agashe’s Maternity and Surgical Nursing Home, Kurla, Mumbai 400070, India
* Corresponding author: email@example.com
Accepted: 17 April 2020
Aim: To highlight radiological features and emphasize the need for tissue diagnoses to confirm bone pathology. Tuberculosis is known to present without constitutional symptoms and with unconventional imaging features mimicking sarcomas as shown in our series of 25 patients; where the imaging and biopsy protocols at our institute helped to solve these diagnostic dilemmas. Material and methods: We retrospectively analyzed clinical and radiological features and tissue diagnoses in 25 patients referred to the department of orthopedic oncology with radiological suspicion of tumor. Results: Only 7 patients had cultures positive for Mycobacterium Tuberculosis T.B. Radiological features suggestive of infection were Metaphyseal and joint involvement, permeative lesions, absence of Codman’s triangle, and soft tissue mass suggestive of a cold abscess. The predictive accuracy of the orthopedic oncologist was 60% and musculoskeletal radiologist was 72% (based on radiology). Final diagnosis is 100% confirmed on histopathology. Conclusion: Diagnosis based primarily upon imaging is a wrong approach. A multimodal approach to differentiating tuberculous bone infections from sarcomas is essential.
Key words: Tuberculosis / Long bone / Tumour / Biopsy
© The Authors, published by EDP Sciences, 2020
This is an Open Access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
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