Primary Sinonasal Tuberculosis: A Diagnostic Challenge

Primary sinonasal tuberculosis remains a diagnostic challenge as it mimics sinonasal granulomatous disease or neoplasms. Its characteristic signs and symptoms may be non-specific and highly variable. Here we report a unique clinical condition of a 24-year-old man who presented with unilateral nasal obstruction and epiphora for 2 years. He was without any comorbidity, was immunocompetent, and was otherwise healthy. Subsequent investigations, including a computed tomography scan of the paranasal sinuses, and perioperative findings revealed a sinonasal mass involving the lateral nasal wall and paranasal sinuses. The histopathology was consistent with the features of tuberculosis. There was no evidence of pulmonary or any other primary tubercular foci elsewhere in the body, suggesting the diagnosis of primary sinonasal tuberculosis.