Sternal tuberculous osteomyelitis presenting as a pulsatile swelling

Primary sternal tuberculous osteomyelitis is a rare form of tuberculous osteomyelitis. We report a case of a young adult with primary tuberculous osteomyelitis of the sternum who presented with a pulsatile anterior chest wall swelling. Computed tomography of the thorax revealed a hypodense lytic lesion in the body of the sternum that had eroded into the anterior mediastinum where it lay in close contact with the right ventricle, resulting in the clinically evident transmitted pulsations. Among the protean manifestations of tuberculosis this case illustrates a unique presentation as a pulsatile chest wall mass.