Tuberculosis masquerading as metastasis in liver: a rare and an unusual presentation

Hepatosplenic space occupying lesions are usually labelled as metastasis. This case highlights the importance of thinking beyond malignancy and the importance of adopting a systematic approach when dealing with such lesions that have a plethora of close differentials. Hepatosplenic tuberculosis is a rare form of extra pulmonary tuberculosis. Timely diagnosis and treatment turned the table from a probable dismal prognosis to a completely curable cause. We report an unusual case, which was provisionally labelled as malignancy, due to isolated liver and spleen involvement but on evaluation turned out to be tuberculosis. The patient got cured with 6 months of anti-tubercular therapy. The report also brings to light the possible use of molecular methods like cartridge-based nucleic acid amplification test in diagnosing hepatobiliary tuberculosis, the literature about which is very scarce and limited.