Extensive Paraspinal Tuberculosis Masquerading Malignant Tumor in an Elderly Male

Area of Science:

• Infectious Diseases
• Oncology
• Neurosurgery

Background:

• Extrapulmonary tuberculosis (TB) can manifest in the paraspinal region, an uncommon but significant presentation.
• Paraspinal lesions in TB can radiologically mimic malignant neoplasms, posing diagnostic challenges.

Observation:

• An elderly male presented with an extensive left paraspinal lesion on imaging, suggestive of a malignant neoplasm.
• Surgical exploration revealed a grayish, avascular lesion involving the paraspinal region, psoas muscle, and neural foramina.
• Subtotal resection and biopsy confirmed the lesion to be a tuberculoma.

Findings:

• Paraspinal tuberculosis can present with extensive soft tissue and bony involvement, closely resembling malignant tumors on imaging.
• Histopathological examination is crucial for definitive diagnosis, differentiating between infectious and neoplastic processes.

Implications:

• This case underscores the need to include tuberculosis in the differential diagnosis for extensive paraspinal masses, especially in endemic areas.
• Conservative surgical excision aids in diagnosis and preserves spinal structures.
• Successful management involves antitubercular therapy post-diagnosis.