Concurrent Intestinal Tuberculosis and Colon Cancer in a Young Patient: A Diagnostic Challenge

Concurrent intestinal tuberculosis and colonic adenocarcinoma are rare and pose significant diagnostic challenges due to overlapping clinical and endoscopic features. We report a 25-year-old woman presenting with right iliac fossa pain, anorexia, and 10-kg weight loss. Colonoscopy showed a proliferative ascending colon growth with adjacent cecal ulcers. Histopathology confirmed adenocarcinoma from the growth, while catridge-based nucleic acid amplification test from the ulcers detected Mycobacterium tuberculosis. The patient received antitubercular therapy, followed by right hemicolectomy and adjuvant folinic acid, 5-fluorouracil, and oxaliplatin chemotherapy. This case emphasizes the importance of obtaining separate biopsies from multiple lesions to identify dual pathology and ensure appropriate sequential management in tuberculosis-endemic regions.