Synchronous pancreatic and scrotal tuberculosis: Double jeopardy

Area of Science:

• Medicine
• Infectious Diseases
• Radiology

Background:

• Tuberculosis (TB) typically affects the lungs, but extrapulmonary involvement can occur.
• Scrotal and pancreatic TB are rare manifestations of Mycobacterium tuberculosis infection.
• Extrapulmonary TB can present insidiously, mimicking other conditions.

Observation:

• A patient presented with non-healing scrotal sinuses post-trauma, initially suspected as an infected hematoma.
• Further evaluation revealed scrotal tuberculosis.
• The same patient had an upper abdominal mass, diagnosed as pancreatic tuberculosis via ultrasonography.

Findings:

• Both scrotal and pancreatic lesions were confirmed as tuberculosis.
• The patient responded well to standard anti-tubercular therapy.
• This represents an unusual co-occurrence of two rare extrapulmonary TB sites.

Implications:

• Clinicians should consider tuberculosis in endemic areas when evaluating non-healing ulcers, sinuses, or unexplained mass lesions.
• Tuberculosis can present as a 'great masquerader,' mimicking various pathologies.
• Simultaneous rare extrapulmonary TB sites highlight the diverse clinical spectrum of the disease.