Colonic tuberculosis mimicking malignancy: a multidisciplinary medical and surgical approach

Colonic tuberculosis (TB) is a rare form of extrapulmonary TB with nonspecific clinical presentations such as weight loss, abdominal pain and fever. It is often misdiagnosed, as the presentations mimic other more common diseases such as colon cancer and inflammatory bowel diseases, especially in those countries with low TB incidence. Although a combination of CT imaging, colonoscopy and histopathology forms the essential part of the diagnostic assessment, the high variability and low specificity of each investigation may delay or overlook the diagnosis. Without treatment, colonic TB could potentially lead to severe malnutrition, bowel obstruction and mortality. We report the case of a man in his 60s presenting with significant weight loss, malnutrition and an abdominal mass for an initial workup of colorectal malignancy. This case highlights the diagnostic pitfall and dynamic management of colonic TB and aims to raise awareness among clinicians to broaden differential diagnoses when encountered with unspecific presentations.