An Unusual Cause of a Pancreatic Mass: Pancreatic Tuberculosis

Isolated pancreatic tuberculosis (TB) is an exceedingly rare disease, even in countries with a high burden of TB. We report the case of a 40-year-old gentleman who presented with a two-week history of fever and abdominal pain. Computed tomography of the abdomen showed a large heterogeneous mass arising from the pancreas with peri-pancreatic lymphadenopathy, infiltration of the stomach, and encasement of the celiac vessels-highly suggestive of pancreatic malignancy. Oesophagogastroduodenoscopy with endoscopic ultrasonography was performed, which showed a necrotic area in the body of pancreas. Fine needle aspiration from the necrotic area was positive for Mycobacterium tuberculosis by polymerase chain reaction (PCR) and culture methods. This case demonstrates an unusual presentation of TB with predominant involvement of the pancreas in the absence of pulmonary or systemic involvement. Clinicians need to be aware of this unique presentation of tuberculosis in order to avoid misdiagnosis and institute timely treatment.