Maxillary myxoma misdiagnosed as tuberculosis

Area of Science:

• Oral and Maxillofacial Surgery
• Pathology
• Pediatric Medicine

Background:

• Tuberculosis (TB) diagnosis can be challenging, especially in pediatric cases with atypical presentations.
• Maxillary myxomas are rare benign tumors that can mimic other pathologies.
• A positive Mantoux test and TB contact warrant careful differential diagnosis.

Observation:

• A three-year-old girl presented with prolonged fever and facial swelling, initially suspected as tuberculosis (TB) due to a positive Mantoux test and maternal TB history.
• Despite initiating anti-tuberculous therapy (ATT), the swelling persisted, prompting further investigation.
• A Caldwell-Luc procedure revealed gelatinous tissue, inconsistent with typical TB.

Findings:

• Histopathological examination confirmed the tissue as myxoma, with negative TB cultures.
• The patient's condition was not tuberculosis, despite initial clinical indicators.
• Surgical excision was recommended by the ENT department.

Implications:

• This case highlights the importance of histopathological confirmation for TB diagnosis, even with suggestive clinical signs.
• Misdiagnosis of maxillary myxoma as TB can lead to unnecessary and potentially harmful anti-tuberculous therapy.
• Accurate tissue diagnosis is crucial for appropriate management of pediatric facial swellings.