Unusual Manifestation of Extrapulmonary Tuberculosis: A Soft Tissue Mass in an Immunocompetent Patient

We report a case of disseminated tuberculosis (TB) manifesting as a soft tissue mass of the back associated with pain and difficulty walking. Its clinical presentation poses diagnostic challenges and can sometimes mimic neoplasms. The first imaging study with computed tomography was suggestive of metastatic bone disease or locally advanced malignancy. Advanced imaging studies, such as magnetic resonance imaging (MRI) or computed tomography (CT), are required to evaluate the extent of organ involvement. A definitive diagnosis necessitates histopathological analysis and microbiological confirmation through acid-fast Bacilli staining and polymerase chain reaction (PCR) testing for Mycobacterium tuberculosis (MTB). Disseminated TB is rare in immunocompetent patients, which accounts for <2% of all TB cases. It usually occurs from progressive primary infection or the reactivation of latent infection focus through lymphohematogenous spread. The risk of communicable diseases has increased due to recent migration, so it is important to investigate MTB in patients with unusual presentations, especially for people from endemic areas.