Tuberculosis presenting as metastatic lung cancer

Area of Science:

• Medical diagnostics
• Infectious diseases
• Oncology

Background:

• Tuberculosis (TB) is a significant global health concern.
• While TB can present as a lung tumor, its mimicry of metastatic thoracic cancer is uncommon.
• Early and accurate diagnosis is crucial for effective treatment and patient outcomes.

Observation:

• A young male smoker presented with symptoms and imaging indicative of lung cancer.
• Radiological findings included a speculated lung mass, lymphadenopathy, and a sacral lesion.
• FDG-PET-CT revealed hypermetabolic lung lesions with widespread metastatic involvement.

Findings:

• CT-guided biopsy confirmed necrotizing granuloma, and M. tuberculosis was identified.
• The patient showed complete resolution of lung and lymph node lesions after anti-TB treatment.
• Significant reduction in the sacral lesion was observed post-treatment.

Implications:

• Mycobacterial infection can present as metastatic thoracic cancer, challenging clinical diagnosis.
• TB should be considered in the differential diagnosis of patients with suspected lung cancer and distant metastases.
• This case underscores the need for comprehensive diagnostic workups to differentiate between infectious and malignant conditions.