Voit FM, Abdelhafez M, Rothe K, Slotta-Huspenina J, Gaa J, Schmid RM, Spinner CD. [Disseminated tuberculosis mimicking metastatic gastric cancer - a case report].
Z Gastroenterol 2019;
57:1487-1492. [PMID:
31826280 DOI:
10.1055/a-1030-4781]
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Abstract
Increasing numbers of active tuberculosis in Germany were recorded in the last years. Thus, also extrapulmonary manifestations of tuberculosis gain clinical significance as differential diagnoses, especially when a metastatic tumor disease is suspected. We report the case of a 77-year-old male patient who presented with unilateral leg pain and B symptoms. Further investigations revealed an osteolytic mass in the sacrum as well as CT-morphological findings consistent with metastatic gastric cancer. However, transgastric biopsies showed necrotising granuloma with giant cells leading to molecular and cultural detection of Mycobacterium tuberculosis instead of suspected neoplastic tissue. A nine-month treatment regimen for suspected disseminated tuberculosis with bone involvement was initiated according to national guidelines. Clinical and radiological follow up examinations after treatment completion showed complete remission.
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